Facility Evaluation Report

On this day, December 5, 2022, Licensing Program Analyst (LPA) Delmundo arrived unannounced to conduct a health and safety inspection as a result of the Department receiving a priority 2 complaint (Complaint # 15-AS-20221130092446). LPA met with Associate Director Margaret 'Maggie' Shapiro, and informed the reason for visit.

LPA toured the facility including but not limited living room, kitchen, dining room, bathroom, backyard. LPA randomly selected 5 rooms, 2 on the first floor and 3 on the second floor. Food supplies were observed sufficient good for 7 days of non-perishables and 2 days of perishables. Hot water temperature was tested on one of the lavatories in the shower room on the first floor.

At 5:00 pm, hot water temperature was tested and measured at 129 degrees Fahrenheit.

Missing door cabinet in one of the bathrooms on the second floor.

Upon interview and verification, LPA learned from Margaret Shapiro that one of the residents was sent out 3 times. The first time this particular resident was sent out was November 27 or 28, 2022 and facility failed to report to the Department followed by a written report.

Deficiencies are cited from Title 22 California Code of Regulations and listed on 809D. A $250.00 civil penalty is assessed for repeat violation of sectio n # 81087(a ) within 12 month period. Failure to submit proof of corrections by plan of correction due dates may result in additional civil penalties.

Deficiencies and plan and proof of corrections were discussed. Exit interview conducted. Appeal Rights, LIC421FC Civil Penalty, LIC9098 Proof of Correction form, and copy of this report provided.