Facility Evaluation Report

On 04/20/26, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit, and met House Manager Nelsalina Davis-Shabazz. Administrator/ Licensee Sheila Bagsby was called and arrived shortly. LPA toured facility with Licensee. All five clients were present during inspection. One client left to day program during inspection.

The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside and outside. All clients’ and sample of staff files were reviewed. Medications observed locked in medication cabinet in common area. Clients’ MARS was reviewed, and medications were checked. Fire extinguisher was observed with a purchased date 07/25/25. Fire drill last completed on 03/31/26. An adequate supply of perishable and non-perishable food was observed. Freezers temperature was maintained at 0 degrees F, refrigerator temperature was maintained at 31 degrees F. All clients' bedrooms toured and observed to be adequately furnished and adequate lighting. Bathrooms were properly equipped. Hot water temperature was tested at 105.4 degrees F in hall bathroom and tested at 106.9 and 106 degrees F in the share bathroom.

Cleaning supplies and chemicals are kept in locked under kitchen sink, in hall closet, and in garage cabinet. Outside of facility toured. Side gate was self-closing and self-latching with free of debris. Outside was observed with adequate outdoor seatings available for clients. First Aid Kit observed with required items. Carbon monoxide and smoke detectors were tested and observed to be operational.

A deficiency is being cited, per California Code of Regulations, Title 22, Division 6, see attached 809D. Exit Interview conducted. The requested documents are to be submitted to the department by 04/27/26: Lic 308, Lic 500, Lic 610D, Lic 9020, current Administrator certificate, and control of property. A copy of this report and appeal rights was provided to Licensee, whose signature on this form confirms receipt of this report.