Facility Evaluation Report
Licensing Program Analyst (LPA) Sarah Hurt conducted an unannounced visit today for the facility’s annual inspection. LPA met with Facility Director, Jocelyn Kosgeryan. There are currently 23 clients receiving services at this location LPA inspected the interior and the exterior of the facility including the common spaces, activity rooms, transportation and outdoor areas.
Fire extinguisher is within the safety regulation period. Smoke alarms were tested and are operational. The home has a carbon monoxide detector and performs disaster drills as required. Water temperature was tested at 111 degrees. First Aid kits do not have all required supplies. Toxins and cleaning supplies were in bathroom area unlocked and accessible to clients. This facility does not provide food service. LPA reviewed Emergency Disaster Plan, Infection Control Plan, a sample of client, and staff files.
LPA observed the facility client art room bathroom toilet to be dirty, bathroom walls dirty, activity materials cluttered and disorganized, and trash scattered around the outside of the facility. LPA observed the facilities client bathroom water temperature measured to be 134 degrees. Infection Control Plan and Emergency Disaster drill not reviewed annually. Quarterly disaster drills not being conducted. Client 1's Medical assessment or Pre Placement Appraisal. Client 2's medication is not logged on the Centrally Stored Medication Record. LPA observed medications in first aid kit accessible to clients. Staff 1 does not have required Personnel training available to review.
The following deficiencies observed or cited during today's inspection per California Code of Regulations, Title 22.
LPA requested the following documents: LIC 500 Personnel Report, LIC 308 Designation of Administrative Responsibility, LIC 610-E the Emergency Disaster Plan and copy of current Administrator’s Certificate to update the facility file. Listed documents shall be sent to Licensing.
Exit interview conducted with Facility Director, Jocelyn Kosgeryan, and copy of report left at facility
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction