Facility Evaluation Report

Licensing Program Analyst (LPA) Ashley Calderon conducted an unannounced visit for the purpose of conducting the required annual inspection. On today's visit LPA met with Caregiver/ House Manager: Rosanna Reyes who assisted with the visit.

LPA and Reyes toured the facility physical plant which consists of six bedrooms, one which is a staff bedroom/ office, 2 bathrooms, living room, dining room, laundry room, backyard and a detached garage. Garage is used for storage, contains extra food, emergency supplies, and PPE supplies, garage is inaccessible to clients. LPA Calderon reviewed food supply: non-perishable and perishable food items enough for 7 clients. LPA reviewed food menu and did no obverse any expired food items in the pantry. Bedrooms have the required furniture linen, dressers, lamps and chairs. Passageways and exits are free of obstruction. LPA observed telephone for resident to use and LPA observed stocked First Aid Kit. The clients bathrooms are clean and showers have non-skid mates. LPA measured hot water temperature measured at between 105 - 120 *F. The facility temperature at the time the visit was comfortable. There is sufficient lighting throughout the facility. There are smoke detectors and carbon monoxide detectors are located throughout the facility; LPA tested detectors and were operational.

LPA conducted Infection control domain with Reyes, Covid-19 signs were observed throughout the facility, staff were masked and LPA observed temperature sign in sheets for staff, clients and visitors.

In addition, LPA Calderon reviewed four clients medication supplies and records and reviewed one staff file containing first aid certificate and noted no deficiencies. Administrator Certification for Carol Liess Expires 2/25/23.

Per California Code of Regulations, Title 22, and California Health and Safety Code, there were no deficiencies observed during the visit. Exit interview held and a copy of the report was provided.