Facility Evaluation Report

At 12:30 PM Licensing Program Analysts (LPAs) Melissa Ruiz and Joscelyn Martinez conducted an unannounced annual inspection at the facility mentioned above. LPAs were greeted by Administrator Eileen Tagdulang. This is a seven (7) bedroom and three (3) bathroom single story Adult Residential Home. A physical tour was initiated at 12:30 p.m. and observed the following:

Infection control: No infection control signs were observed outside the facility. LPAs reminded Administrator to place covid-19 signage outside the entrance. Upon entering the location, LPAs observed the sign in station which contained thermometer, hand sanitizer, and visitors sign in sheet. LPAs’ temperature were recorded. Sufficient PPE supplies were observed. Food Inspection: LPAs observed there to be sufficient stock of one-week non-perishable foods and two-day perishable foods. Food storage and preparation areas are clean and inaccessible to pests. At 12:45 P.M. sharps were observed on the dish rack and in an unlocked drawer, which were accessible to clients. Cleaning supplies are centrally stored in a designated room near the laundry room. Smoke detectors/carbon monoxide are dual hardwired throughout the facility. At 12:50 P.M alarms were tested and appear functional. Fire extinguisher has a date of purchase of 02/09/22. Client rooms: There are five (5) designated rooms for clients. LPAs were then escorted through the home and observed the client’s rooms to be properly furnished. Bathrooms: There are two (2) restrooms designated for clients LPAs observed the bathroom which contained paper towels, hand sanitizer, and trash cans with closed tight-fitting lids. The water temperature read 105.9 F. Outside areas: LPAs toured the outside area of the facility. LPAs observed appropriate outdoor furniture, with a covered shaded area. There is a body of water which is fenced and kept locked

Deficiencies were issued per CA code of Regulations Title 22 or Health and Safety Code. See 809D included with this report. Appeal rights issued. Report delivered. Exit interview conducted.