Facility Evaluation Report

On 1/22/25 Licensing Program Analyst (LPA) M. Garza arrived unannounced for an annual inspection visit. LPA was met by Program Director, Pam Chin. LPA introduced self, explained reason for visit and was permitted entry into the facility.

LPA completed a health and safety check on clients in care. LPA toured the facility inside and out. Facility is 1 large room with 1 restroom and kitchen. Doors were clear and free from obstruction. Facility was clean and without odor. Common areas were clean, adequately furnished, and adequately lit. Smoke detectors and carbon monoxide detectors were present at time of visit. Fire extinguisher last serviced 11/7/24. Last fire drill conducted on 11/20/24. LPA observed sufficient seating in outdoor area.

The following issues were observed during todays visit: Bathroom tile broken/missing and in need of repair. Debris observed behind shed in need of removal. Chemicals and sharps observed in kitchen area and in shed unlocked and accessible to clients in care. Food in refrigerator/freezer not properly stored/dated. Back yard walkway of facility observed with debris in need of removal. Water temperature in bathroom measured at 102.8 degrees F.

LPA requested the following documents to be submitted to CCL by 1/31/2025: current copy of Administrator Organization (LIC 309), Designation of Administrative Responsibility (LIC 308), Emergency Disaster Plan (LIC 610-E), Personnel Report (LIC 500), Register of Facility Clients/Residents (LIC 9020) in order to update the facility file.

Deficiencies cited per Title 22. Exit interview completed with Program Director, Pam. A copy of this report, deficiencies and TV’s were provided.