Facility Evaluation Report

On 1/10/22 at 9:10 AM, Licensing Program Analyst (LPA) Malia Thao arrived unannounced to conduct an Annual inspection. LPA explained reason for inspection and was granted entry by staff. House Manager (HM) Samira Hernandez and Administrator (ADM) Christie O'Neal arrived a short time later.

LPA toured facility inside and outside of facility with staff. Hand sanitizer was available to residents and visitors. Social distancing is maintained in the common and dining areas. Hand washing posters were observed next to the sinks. Bedrooms were checked and no residents share a room. LPA checked residents’ medications and observed the month's supply. Food supply was observed in adequate supply. Cleaning and PPE supplies were checked. Staff records were reviewed for good health. Residents files have updated emergency contact information. Administrator certification is valid.

1. Hot water in south hall bathroom measured at 137.4 degrees F.

2. South hall bathroom shower light not operating and bathtub spout leaking water. Bedroom #4 bathroom sink faucet leaking water. Ramp outside laundry area in disrepair. LPA observed an approximately 12" x 18" size cut out in ramp with board inside cut out to cover opening inside ramp walkway. Fire exit gate not operating as self-closing, is hanging by top hinge, and has nails sticking out of door.

The following update forms to be sent to CCL within 2 weeks:

Deficiency is being cited based on LPAs' observations and interview in accordance with the California Code of Regulations, Title 22, see LIC809D. Exit interview conducted. Due to COVID-19 precautionary measures, a copy of this report and appeal rights were emailed to email on record with "Read receipt" to confirm receipt of this report. LPA verified email on record is correct with Administrator Christie O'Neal.