Facility Evaluation Report

Licensing Program Analyst (LPA) Felisa Shirley conducted an unannounced Annual inspection visit and infection control inspection to the above facility. LPA was met with Sharon Babbs, Administrator and the purpose of today’s visit was explained.

The facility is a single-story structure located in a residential neighborhood. It consists of the following: 3 bedrooms, 2 bathrooms, family room/office, living room, kitchen, dining room, shaded back porch, indoor and outdoor activity area, covered front porch with ramp, shaded side patio with ramp, and laundry room in the attached 2 car garage.

LPA Shirley and Sharon toured the entire facility inside and out. All bedrooms are occupied by clients and contain the mandated furniture. The (2) bathrooms are clean and operational. Water temperature measured at 100.8. Smoke detectors and carbon monoxide detector comply and operational. No firearms are stored at facility and no bodies of water present. Medications are stored, locked and inaccessible to clients. A comfortable temperature is maintained in the facility. Ample supply of perishable and nonperishable food, linens and personal hygiene supplies are adequate, hazardous toxins and/or items are inaccessible to clients, (2) fire extinguishers are fully charged. First Aid kit complete and with manual. Exit, walkways and/or passageways, front and back yard are free of debris and/or hazards. The facility is in good repair.

According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA did not observe any deficiencies, therefore no citations were issued at this time.

An exit interview conducted with Ana Diaz, Caregiver and copy of report provided.