Facility Evaluation Report

Licensing Program Analyst (LPA) Luis Mora conducted an unannounced annual visit at the facility using the CARE Tool. LPA Mora met with Dominador Bartolata (Facility Manager) and explained the reason for the visit. The facility is licensed to serve 4 ambulatory clients only ages 18-59. Facility is operating within the scope of its license.

A tour of the single-story facility included the living room, kitchen, 4 client bedrooms, 2 bathrooms, office, front yard, backyard, and attached garage. LPA Mora conducted the tour with Dominador Bartolata and observed the following: sufficient food supplies for at least 2 days of perishables and 7 days of non-perishables were observed in the kitchen and refrigerator in the garage. Sharps and cleaning chemicals were observed locked in the garage. The First Aid kit is kept locked in the medication cabinet and it is fully stocked with all required items including a current manual. Clean towels and extra clean linen were observed in the hallway cabinets. Dining and living room have sufficient lighting and sitting area. Medications are kept locked in the living room. Client and staff files are kept locked in the office. All bedrooms have all required furniture, lighting, and bedding. The bathrooms were observed with shower mats. The water temperature was tested in the both bathrooms and measured at 106 degrees F, which is within the required 105-120 degrees F. A fire extinguisher was observed in the kitchen and it is fully charged. Smoke detectors were observed throughout the facility and in each room and were operable during the visit. A carbon monoxide was observed in the kitchen and it was operable during the visit. The front yard and backyard are clean. There is a shaded area with seating in the backyard. No bodies of water were observed at the facility. Passageways and exits are free of obstruction.

LPA reviewed medication for 3 clients (1 client does not have medication prescribed) and observed that medications are documented properly and given as prescribed. LPA reviewed files for 4 clients and 5 staff and observed no deficiencies. LPA observed an administrator certificate for Jerica Acero - 6062666735 that expires on 04/25/2024. LPA interviewed 2 staff and 2 clients.

Per California Code of Regulations, Title 22, and California Health and Safety Code, there was no deficiencies observed during the visit. Exit interview held and a copy of the report was provided.