Facility Evaluation Report

On 06/18/25, Licensing Program Analyst (LPA) L. Salazar arrived at the facility unannounced to conduct the required annual inspection. LPA was greeted by Program Coordinator, stated the purpose of the visit, and was allowed entry into the facility. Program Director arrived shortly after.

LPA toured the facility inside and out. LPA observed clients to be present with appropriate staffing levels at the facility during the inspection. LPA observed the required hand washing signs in client restrooms. The facility was observed to be free from odor. Facility temperature measured at 74 degrees F. Disinfectants and cleaning supplies were observed to be locked in a room and inaccessible to clients. Hot water was tested and measured 115.8 degrees in the common bathroom.

Emergency disaster plan and procedures are in place. Last drill was earthquake and was conducted on 05/10/25. Doors and passageways were observed to be free from obstruction throughout the program. Fire extinguishers were observed with a service date 05/11/25. Emergency numbers were observed to be posted. First Aid kits were observed to have the required items. A sample of staff and client files were observed to have the required training and forms.

Staff and client records will be reviewed at the main office and will be documented on an annual continuation report. LPA requested the following updated forms to be faxed to CCLD by 06/30/25: Personnel Report (LIC 500), Client Roster (LIC 9020), Emergency Disaster Plan (LIC 610D), Infection Control Plan (LIC9282), Designation of Responsibility (LIC 308), Administrative Organization (LIC400) . An exit interview was conducted with Program Administrator and a copy of this report was sent via email. No deficiencies cited on today's visit.