Facility Evaluation Report

On 4/26/24 Licensing Program Analyst (LPA) M. Garza arrived unannounced for an annual inspection visit. LPA was met by Lead Staff, Lynda Sanford and Program Support Specialist, Amber Rubio. LPA introduced self, explained reason for visit and was permitted entry into the facility.

LPA completed a health and safety check on residents in care. 4 of 4 residents attending program at time of visit. LPA toured the facility inside and out. Pathways and doors were clear and free from obstruction. Facility was clean and without odor. Common areas were clean, adequately furnished, and adequately lit. Smoke detectors and carbon monoxide detectors present and operational at time of visit. Fire extinguisher last serviced 6/15/23. Last fire drill on 2/4/24. Resident rooms observed to have the required furnishings and with adequate lighting. Linen supplies are kept in staff restroom cabinet. Sharps are kept in locked kitchen drawer. Chemicals kept in bathroom cabinets. Medication kept locked kitchen cabinet. LPA observed sufficient seating under covered area.

LPA requested the following documents to be submitted to CCL by 5/3//24: current copy of Administrator’s Certificate, Administrator Organization (LIC 309), Designation of Administrative Responsibility (LIC 308), Emergency Disaster Plan (LIC 610-D), Affidavit regarding Resident Cash Resources (LIC 400), Personnel Report (LIC 500), Register of Facility Clients/Residents (LIC 9020) in order to update the facility file.