Senior Care Records.

Facility Evaluation Report

Powelson Home IV, Canoga Park10/27/2022Licence 197606438

Capacity6
Census5
Date signed10/27/2022 11:34:12 AM
The inspector’s account

Licensing Program Analyst (LPA) Michael Cava conducted an Annual Required visit and inspection of the facility. LPA met with the administrator, Ruth Ramos and explained the reason for the visit.

At approximately 9:15am, with the assistance of the administrator, LPA took a tour of the physical plant. Required postings were observed in the entry area. The smoke alarms are battery operated. The carbon monoxide detector functions properly. The fire extinguisher is located in the kitchen. The charge date is 5/26/2022. The last fire drill was conducted in September 2022.

Kitchen: The kitchen appliances and fixtures were functional. LPA found a sufficient amount of perishable and non-perishable food at the facility; properly stored. Knives were stored in a locked drawer in the kitchen.

Bedrooms: There are a total of five (5) bedrooms in the home. Four (4) of the bedrooms are designated for residents' use. Each of the resident bedrooms were properly furnished with appropriate beddings and linens with sufficient lighting. The fifth bedroom is designated for staff use.

Bathrooms: There are a total of two (2) bathrooms in the home which are all designated for residents' use. Both bathrooms were properly supplied and had functional fixtures. Hot water temperature was measured at 105 degrees Fahrenheit. No toxins or hazardous items observed as cleaning supplies is not kept underneath the kitchen sink

Common Areas : These included the living room and dining area. The common areas were properly furnished. Floors were clean and maintained and furniture is in good repair. Staff work station is in between the resident and staff rooms. Properly labeled medications were locked in a cabinet at the dining room area.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction