Facility Evaluation Report

Licensing Program Analyst (LPA) Ana Soto conducted an unannounced Annual inspection visit and infection control inspection to the above facility. LPA was met with Leilani Le, Administrator and the purpose of today’s visit was explained.

There are currently (4) client's in the facility.All (4) clients are ambulatory. (0) non-ambulatory. The facility is a two-story structure located in a residential neighborhood. It consists of the following: 6 bedrooms, 6 1/2 bathrooms, office, living room, kitchen, dining room, activities room, shaded area, indoor and outdoor activity area, laundry room and attached 2 car garage.

LPA and Administrator toured the entire facility inside and out. Documents are posted as mandated by the DPH and CCLD. Bedrooms 1 & 2 are occupied by clients and contain the mandated furniture. Bedroom 3 is a staff bedroom. The (2) bathrooms are clean and operational. 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. 1 staff file is current, 1 resident file is current along with medications. The water temperature is at 120 degrees. 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, () 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.