Senior Care Records.

Facility Evaluation Report

Kokumah Everyday Grace One Incorporation, Walnut06/02/2022Licence 198602858

Capacity4
Census3
Date signed06/02/2022 02:15:25 PM
The inspector’s account

Licensing Program Analyst (LPA) Vasallo conducted an annual required visit. LPA met with Administrator, John Wilson and explained the reason for the visit. LPA used the infection control tool to evaluate the facility. LPA observed the physical plant, COVID-19 procedures, reviewed clients' medications and records and observed the food supply. The facility cares for adults with intellectual disabilities and is vendorized by San Gabriel/Pomona Regional Center as a Level 4G facility.

All client bedrooms were toured. Each bedroom has a bed, linen, dresser, light, and sufficient closet space. Both client bathrooms were toured and the hot water was 106.4 degrees which is within the required 105 - 120 degrees. There were no toxic chemicals accessible to clients. All chemicals are locked in the garage. The kitchen was inspected. There is sufficient perishable and non-perishable food. There is additional food in the garage. All the appliances are clean and are operating properly. The common areas include the living room and dining area. These areas are clean and have the required furniture. There is a screening station at the entrance of the facility which has PPEs and a thermometer to screen visitors. Staff document client temperatures daily and require visitors to sign in. Facility currently has at least a 30-day supply of PPEs. There are no cameras inside or outside the facility.

Client files were reviewed to confirm emergency contacts are updated. Staff files were reviewed to confirm health screenings, training and fingerprint clearances. All clients' medications were reviewed. Medications are documented properly and given as prescribed.

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

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction