Facility Evaluation Report

Licensing Program Analyst (LPA) Christina Valerio arrived unannounced to conduct an annual required visit. LPA Valerio rang the door bell twice and contacted Administrator Zully Six. Administrator Zully stated she would arrive at the home between 2:40 - 3:15 PM. LPA Valerio was later met Administrator Zully.

LPA Valerio and Administrator toured the physical plant to ensure compliance with Title 22 regulations. LPA Valerio observed the kitchen area, dinning room, and common area. Areas were observed to be clean, organized, and free from debris. The facility meets the food requirement of 7 days of non-perishables and 2 days of perishables. LPA observed the facility to have an emergency supply of food and supplies in the downstairs area. Resident bedrooms were observed to be clean and free from odors. Resident bathrooms were observed to be clean and fully stocked. Hot water was measured between the regulatory range of 105.0 - 120.0 degrees. The facility temperature was observed to be at a comfortable temperature for residents and staff. All sharps, toxins, and cleaning supplies were observed to be locked away and inaccessible to residents in care.

Residents were observed coming home from Day Program and work. Residents were observed playing video games, going on an outing with staff, and cleaning their room. Staff were observed talking to the residents, preparing dinner, and taking resident on an outing.

LPA Valerio reviewed 2 resident files and 2 staff files. Files were observed to be complete and up to date with current information. LPA Valerio requested the following annual documentation be sent to the Regional Office: LIC 500 Personnel Report, LIC 308, LIC 610D, and copy of surety bond

Per California Code of Regulations (CCR) - Title 22, no deficiencies are being cited today. An exit interview was held, and a copy of this report was provided to Administrator Zully Six.