Facility Evaluation Report

Licensing Program Analyst (LPA) Mary Flores conducted an unannounced annual visit at the facility using the CARE inspection tool. LPA met with Imelda Jonson and explained the reason for the visit.

Facility is a two-story home licensed to serve 9 adults between the ages of 18 to 59 years old, ambulatory only. Facility has 5 client bedrooms, 2 client bathrooms, a balcony, 1 staff bedroom with a private staff bathroom, a kitchen, laundry, living room and dining/office room and a detached garage.

LPA conducted a tour of the facility with Imelda Jonson and observed the following:

Facility is in good repair indoor and outdoor. Living room has a fireplace that has been covered. Dining room/office area is clean. Kitchen is clean, in good repair, cleaning supplies are stored inaccessible to clients under the sink, and sharps are inaccessible in a drawer. Refrigerators/Freezers are maintain at 35 degrees F., and 0 degrees F. Food supplies are sufficient for at least 2 days of perishables and 7 days of non-perishables. Laundry area is clean. Five client rooms were observed clean, with the required furniture, sufficient lighting, and bedding supplies. Two bathrooms were observed clean and in good repair. Water temperature was tested between 120.3-122.2 degrees F., which is not within the required 105-120 degrees F. Facility has two indoor stairways. No evacuation emergency chairs were observed. Backyard is clean and provides a shaded seating area. No large bodies of water were observed.

LPA reviewed medication, P&I money, and medication for 5 clients and 5 staff files. Administrator certificate was observed for Carol Leiss #6025209735 exp. date: 2/25/25. Emergency Disaster Plan (10/03) was reviewed and does not meet Health and Safety Code requirements. Infection Control Plan was reviewed.

Deficiencies were noted per Title 22 Regulations. Exit interview was conducted with Imelda Jonson and a copy of this report, LIC 809D, and appeal rights were provided.