Facility Evaluation Report

On 2/7/2024 at 1:50PM, Licensing Program Analyst (LPA) G. Luk conducted an unannounced Health & Safety inspection as a result of a priority 1 complaint. LPA met with Caregiver, Henry Sevilla and explained the purpose of the visit.

LPA toured facility including but not limited to the bedrooms, bathrooms, kitchen, common areas, garage, and outdoor area. Hot water temperature was measured at 113.6 degrees F in the hallway bathroom. 7-day of non-perishable and 2-day of perishable food supplies were sufficient. Resident's medications were kept locked in the kitchen cabinet. Smoke and carbon monoxide detectors observed. First-aid kit was complete. Fire extinguisher was observed to be full and purchased on 7/10/2023. There are no accessible bodies of water observed.

At 2:10PM, LPA observed unlocked comet in the hallway bathroom. LPA observed cabinet under the kitchen sink was unlocked and cleaning supplies were unlocked. Kitchen knives drawer was unlocked. Staff locked up the cabinets and drawer during inspection.

At 2:20PM, LPA observed portion of the side fence has fallen down into the neighbor's yard. LPA observe the other side fence is leaning.

The deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22. Failure to correct deficiencies may result in civil penalties.

Exit interview conducted. A copy of this report and appeal rights provided.