Facility Evaluation Report

A pre licensing visit was conducted by Licensing Program Analyst (LPA) Jaclyn Avila. LPA met with the Administrator, Ifeanyi Ezeani.

Facility was toured inside and outside. The facility offers 5 client bedrooms for a capacity of 10 clients. The facility offers four bathrooms, one living room, dining area, kitchen, laundry room, detached activity room and an outside yard area. The facility has a medication room for locked medications. Sheets, pillow cases and towels are available, there is adequate drawer space, there is a locked room for cleaning supplies, an area for staff and client records, first aid supplies and one telephone is available for client use. The licensee agrees to maintain the hot water temperature between 105 and 120 degrees F.

Components III of the Orientation process was completed during today's visit. Additionally LPA went over mandated reporting and provided the mandated reporter flow chart.

The Fire Marshal has approved the fire safety inspection request.

During the tour of the outside grounds, the following areas were identified as needing to be corrected prior to licensure: Weed abatement, leveling of yard, cleaning of roof and gutters, removal of dead tree limbs as they pose an immediate risk to clients in care during fire season. Ref Title 22 CCR 81087 Building and Grounds. Additionally, licensing is requesting the kitchen sink to be evaluated by a certified professional for leaks and mold. The fire map needs to updated to reflect a wall that was removed between the office and what the map identifies as room bedroom #107.

Pre-Licensing is incomplete with deficiencies to be resolved by July 5th, 2022 . A follow up Pre-licensure visit will be conducted upon resolution of deficiencies.

Exit interview conducted. No citations were issued and a copy of this report will be submitted to CAB.