Facility Evaluation Report

ST. Mary's Home, Union City11/26/2024Licence 015600552

Capacity6
Census5
Date signed11/26/2024 05:05:51 PM
The inspector’s account

On 11/26/2024 at 2:10 PM Licensing Program Analysts (LPAs) Patricia Manalo and Luisa Fontanilla arrived unannounced to conduct 1-Year Annual Required inspection. LPAs met with Care Staff, Georgia De Jesus, who phoned the Administrator, Jovita Bolloso, the purpose of our visit. The Administrator arrived to the facility shortly after. The facility’s fire clearance was approved for all six (6) ambulatory only.

LPAs toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 5 total bedrooms which 4 bedrooms are occupied by the clients and 1 bedroom is occupied by staff. There are no bodies of water. LPAs observed lighting in all rooms are adequate for the comfort and safety of the clients. All toilets, hand washing and bathing are safe, sanitary and in operating condition. The supply of extra hygiene's and linen supplies was available for clients. There is a minimum of one week supply of nonperishable and 2-day perishables food supply. Outdoor activity space was observed furnished with tables, chairs and shade.

Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 12/03/2023. First aid kit was observed to be complete. Emergency Disaster Drill was last posted on 05/15/2024. Fire Drill was last conducted on 11/03/2024.

At 2:19 PM, 5 of 5 clients records were reviewed. At 2:45 PM, 3 staff records were reviewed, 3 of 3 has First Aid Certification and 3 of 3 associated to the facility. At 3:45 PM, LPAs reviewed client's P&I money with log and there was no discrepancies observed. At 4:15PM, LPAs reviewed 3 of client's medications.

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