Facility Evaluation Report

Licensing Program Analyst (LPA) Tao conducted an unannounced annual inspection visit. Upon arrival, LPA met administrator Priscilla Nanong, who assisted with the visit. The facility is licensed to serve six (6) Developmentally Disabled Adult clients (ages 18-59), ambulatory only. LPA discussed the purpose of today's visit and the inspection to administrator.

During the visit, LPA completed Care tool, conducted physical plant, interviewed staff/clients, reviewed food supply, reviewed staff/clients files and medications.

The facility is a single family home located in a residential neighborhood. Facility consists of three (3) bedrooms, staff room, office, two (2) bathrooms, living room, dining room, kitchen, laundry area, garage and an indoor/outdoor activity area. Client rooms are furnished with appropriate furniture for clients’ comfort. Bathrooms are operational and furnished with grab bars and nonskid surfaces. Common areas and back yard are in compliance with Title 22. Sufficient supply of perishable and nonperishable foods is observed.

Smoke detectors and carbon monoxide detector are operable and in compliance. Fire extinguishers are fully charged. Hot water temperature measured at 119.7 degrees Fahrenheit which is within Title 22 Regulation guidelines. Adequate linen and personal hygiene supplies are observed. The last Fire/ Emergency Drill was conducted on 3/18/24. Medications are centrally stored, locked and the records are current. Hazardous items are locked and inaccessible to clients. Annual fees are current.

No deficiencies were observed and cited per California Code of Regulations, Title 22. An exit interview was conducted. This report was discussed with administrator. A copy of LIC 809 report was provided.