Facility Evaluation Report

Licensing Program Analyst (LPA) Daniel Konishi made an unannounced case management visit regarding a self-reported incident on the relocation of 3 clients Clayton Cottage Glenrose - License # 1986 00986, 3184 North Glenrose, Altadena, CA 91001 to Clayton Cottage Galen-License # 198600229 due to mandatory evacuation orders from Fire Advisory. LPA met with S1 and explained the purpose of the visit. During the visit, LPA Konishi spoke with the Administrator, Cameron Clayton over the phone and explained the purpose of the visit.

During the visit today, LPA Daniel Konishi conducted a health and safety check, and no concerns were observed. LPA obtained a copy of the client roster for Clayton Cottage Galen and Clayton Cottage Glenrose. LPA obtained a copy of the staff roster for Clayton Cottage Galen but did not obtain a copy of the staff roster for Clayton Cottage Glenrose. The last disaster/fire drill was conducted on 10/14/24.

Per interview with the administrator over the phone, there are 3 clients that have been relocated from Clayton Cottage Glenrose. They have sufficient staffing to meet the needs of the clients. Clayton Cottage Glenrose are providing staffing from their facility to assist residents at Clayton Cottage Galen. Food and hygiene supplies are available to accommodate a total of 9 clients. The facility has 3 bedrooms, 2 bathrooms, 2 living rooms, dining area, and kitchen. The medications and MAR logs for the 3 individuals from Clayton Cottage Glenrose were transferred to the facility and are centrally stored and locked. All the clients in the facility are ambulatory and do not use any assisted devices. All clients in the facility do not require incontinence services. Administrator stated the families, responsible parties, and regional center for Clayton Cottage Glenrose clients have been notified about the relocation either via calls, texts, or emails.

LPA informed administrator to notify the local fire authority of the over capacity and to submit an incident report to appropriate agencies.

An exit interview was held and a copy of this report was given to S1.