Facility Evaluation Report

Licensing Program Analyst (LPA) Christine Wong conducted an unannounced annual required visit. LPA met with the DSP Marcelo Canoza and Lolida Abzebe and explained the reason of the visit. LPA used the infection control tool to evaluate the facility. LPA observed the facility plant, COVID-19 procedures and observed food supply. Facility has submitted a mitigation plan and was approved on 04/10/21

The facility is a single story house located in residential neighborhood. The facility consists of four clients bedrooms, two bathrooms, living room, family room, dining area, second dining area, kitchen and an attached garage. Each client bedroom has one bed, one dresser, one chair, closet and an adequate lighting. All clients bedrooms have required linen which including the mattress pad. The hot water temperature in the bathroom #1 and #2 were measured between 94.2 and 101.3 degrees F which is not within Title 22 regulation. The food supply both perishable and non-perishable is sufficient. The backyard has shaded area and sitting area. The passageways, front, back and side areas are free from obstruction or free of hazards. The smoke detectors and carbon monoxide detectors are inter-connected and they are operational. At 3:10pm, LPA also observed the carpet in the family room and dining area is dirty and has a lot of black stains on it.

Facility is currently following COVID 19 recommendations regarding COVID 19 signs throughout the facility, social distancing by allowing two clients sitting in the dining table, disinfecting products are available in each room and facility is disinfected at least two times per day, restrooms have sufficient hand soap, paper towels, and signs, and PPE supplies are stored for more than 30 days.

Deficiencies are cited on the 809 D. Exit interview conducted and copies of the report and appeal right was provided to the DSP Marcelo Canoza