Facility Evaluation Report

On 12/1/25, Licensing Program Analyst (LPA) Felisa Shirley conducted an unannounced annual required visit. LPA met with the House Manager, Kim Cooper and explained the purpose of today’s visit. The purpose of today’s visit was to conduct the required annual inspection, using the new Care Tool. The facility is licensed to serve 6 developmentally disabled clients (age 18-59); 1 may be bedridden. The census is currently 3. The residents are all Westside Regional Center consumers.

CBG Home, Inc. is a one-story structure located in a residential neighborhood. The facility consists of (3) client bedrooms, (1) staff room, (2) bathrooms, living room, kitchen, dining area, outside sitting area, and the garage is used for storage. Facility maintains all required posting throughout the facility.

LPA conducted a records review of (4) staff records, (3) client records, and (3) client medications. All client & staff records were complete. LPA Shirley and Kim walked through throughout the facility and all common areas such as the living room, dining room, and outdoor patio were all observed. Medications were centrally stored and properly locked, first aid kit was checked and fully stocked . Bathrooms were found to be within Title 22 regulations and were clean and operational. The water delivered at 116.6 F.

LPA observed that there is ample seating and space for all clients. All walkways were clean, and clear of obstructions and hazards. All areas have ample lighting. Smoke/ Carbon Monoxide detectors were operable. The last fire/emergency drill was conducted on 11/11/25. There is (1) charged fire extinguisher. Exterior areas are clean and clear of obstructions and hazards and there are no bodies of water present.

No deficiencies were cited during this inspection visit.

An exit interview was conducted, and a copy of this report was provided to the House Manager, Kim Cooper.