Facility Evaluation Report

On 6/20/23, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct a Annual

visit. LPA introduced self, stated the purpose of the visit, and was greeted by Licensee Jimena Corpuz

LPA was granted entry into the facility. LPA toured facility with Licensee. LPA conducted interviews with staff.

The tour started in the kitchen into the common areas, to the client's bedrooms, and bathrooms. The facility was observed to be at a comfortable temperature of 72 degrees F, clean, in good repair, and no passageway obstructions or fire hazards were observed inside or outside. An adequate supply of perishable and non-perishable food was observed. MARs were reviewed. Medications observed kept locked in kitchen shelf.Fire extinguisher was observed with a service date of: 06/02/23. Fire drill last completed: 06/04/23. Cleaning supplies and chemicals stored and locked tote in laundry room.

LPA toured all resident’s bedrooms and observed 2 single occupant rooms and 1 shared bedroom observed to be 6 feet apart. All bedrooms were observed to have required furnishings and with adequate lightening. Bathrooms were properly equipped, and the hot water temperature was tested at 112.2 degrees F in bathroom 1 and 106.1 degrees F in bathroom 2. Outside of facility toured and observed to be free of debris. Carbon monoxide and smoke detectors were tested and observed to be operational. First aid kit was observed and contained all required items.

All clients’ file reviewed to have update emergency contacts, Admission agreement, and Pre-Appraisal. All

staffs’ files were also reviewed. Staff files were observed to have current First Aid/CPR, Health screening, and Personnel record. Staff are fingerprinted clear and associated to the facility.

No deficiencies issued during this inspection. Exit Interview conducted. The following documents are requested and submitted to Fresno CCL by: 6/26/23. The following updated forms were requested: Lic 308, Lic 400, Lic 402, Lic 500, Lic 610D, transportation procedure, and current Administrator certificate. A copy of this report was provided to Licensee.