Facility Evaluation Report

On 03/07/25, Licensing Program Analyst (LPA) L. Salazar and M. Garza arrived at the facility unannounced to conducted the required annual inspection. LPAs met with Administrator Cheryl McCraw, Certificate #6016103735 expiration 05/04/2024.

Upon entering the facility LPAs observed 2 residents in common area. The facility was observed to be at a comfortable temperature, of 75 degrees F. Facility is free of debris, in good repair, and no passageway obstructions or fire hazards were observed. Common areas were properly furnished and well-lit throughout. LPAs observed Resident R1's rooms to be properly furnished, Resident R2's room does not have a night stand or personal light. Interview with Administrator and R2's IPP from 2022 states R2 has behaviors and items are removed for their safety. No night-lights were observed

LPA toured the facility inside and out. Facility is clean, odor free, and clear from obstruction. LPA observed knives/sharps, disinfectants, and chemicals to be locked and inaccessible to residents. LPAs observed the required 7 day supply of non-perishable food and 2 day supply of fresh perishables to be properly stored. An emergency disaster supply was observed.

LPA observed water temperature in a main resident bathroom and read at 122.3 degrees F. LPA observed fire extinguisher with a service date of 05/09/24 and in good standing. Smoke detectors and carbon monoxide reader was tested and are operable.

LPAs toured facility outside and observed the septic tank area to be under repair. The septic is currently in the process of being emptied and the repair is scheduled to be completed by this weekend, per Administrator. The area was observed to be approximately 4ft x 8ft that is currently covered with 2 pieces of plywood that is taped off with cones surrounding it. LPAs observed no external bodies of water. Outdoor seating area was observed in good repair and available to residents.

LPAs observed resident's medications to match the Centrally Stored Medication and Destruction Record . LPA observed resident files and staff files. Resident files observed to required documents and forms. 2 out of 2 residents in care have outdated physician's reports and 2 out of 2 residents have outdated IPP's. LPAs observed current internal Individual Behavioral Plans (IBP) that are dated in 2024. An emergency disaster plan was observed.

Exit interview conducted. Based on today’s visit and per California Code of Regulations Title 22, a deficiency is being cited, on the attached 809D. Report was signed and copy of this report and appeal rights were provided at the time of visit.