Facility Evaluation Report

NC Home, Union City08/10/2023Licence 015600613

Capacity6
Census5
Date signed08/10/2023 02:24:11 PM
The inspector’s account

On this day at around 9:25 am, Licensing Program Analyst (LPA) Luisa Fontanilla arrived unannounced to conduct an annual required inspection and met with Administrator Teresita McLaughlin. LPA explained to Administrator the purpose of the visit. The facility is a Level 4C home vendored by the Regional Center of the East Bay (RCEB).

Facility has an approved fire clearance for 6 non ambulatory clients.

LPA inspected the facility inside and out including but not limited to client bedrooms, bathrooms, kitchen, dining area, backyard and living area. There was sufficient lighting throughout the facility. No bodies of water were observed. There was sufficient supply of perishable and non-perishable foods. Sufficient blankets, sheets, towels, hand towels were observed. Fire extinguisher in the kitchen area was observed to be full and last inspected on 12/15/2022. First aid kit was observed complete and updated. Smoke detector and carbon monoxide were tested and observed operational.

Last fire drill was completed on July 31, 2023 and last earthquake drill was conducted on 10/30/2022. LPA reviewed P&I money and log. The facility has sufficient amount of surety bond to cover amount of money being handled at one time.

At 11 AM, LPA reviewed 5 client files and 5 staff files. At 12:30 PM, LPA reviewed medications and Medication Administration Record (MAR). At 1:15 PM, LPA interviewed 2 staff present. At 2pm , LPA interviewed 1 of 5 clients.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction