Facility Evaluation Report

On 12/20/24, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct an annual visit.

introduce self, stated the purpose of the visit and requested to meet with Administrator. LPA met with staff Amber Zargoza. Administrator Nikki Cockren was called and arrived shortly. Two clients were present during upon LPA arrival and left the facility during inspection. LPA toured facility with Administrator.

The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside or outside. Fire extinguisher was observed with a service date: 10/06/23. An adequate supply of perishable and non-perishable food was observed. Refrigerator temperature is maintained at 34 degrees F and freezer at 0 degrees F. Cleaning supplies and chemicals stored and locked in chemical closet. Extra linens were observed. Washer and dryer observed operational during visit.All bedrooms were observed to have the required furnishings and with adequate lightening. The bathrooms were toured and observed operational during inspection. Hot water temperature was tested at 114.2 degree F in room A bathroom, 118.2 degree F in room B bathroom, and 114.1 degree F in hall bathroom.

Outside of facility toured and observed to be free of debris. Adequate outdoor seatings available for clients. Side gate observed self-latching and self-closing. Smoke detectors and carbon monoxide were observed operational during visit. All clients’ and sample of clients’ and staff files were reviewed to have all required documents. First Aid kit observed with all required items. Medications were observed locked facility office drawer. MARS were reviewed and medications were checked.

A deficiency is being cited, per California Code of Regulations, Title 22, Division 6, see attached Lic 809D. Exit Interview conducted. LPA received copies of Lic 308, Lic 500, Lic 610D, Lic 9020, and current Administrator certificate. A copy of this report and appeal rights was provided to Administrator, whose signature confirms received of this report.