Facility Evaluation Report

` Licensing Program Analysts (LPA) Jewel Baptiste conducted an unannounced visit for the purpose of conducting the required annual inspection. On today's visit LPA met with Administrator, Stephanie Baynosa and explained the reason for the visit. LPA and administrator toured the facility together.

Facility is licensed to served 4 clients between the age of 18 and 59 years old which shall be ambulatory. The facility is a single story building in a residential area, with 4 bedroom, 2 bathrooms, a commercial kitchen, 2 dining rooms, garage and backyard with a shed. Carbon monoxide/ smoke detectors were tested and in working condition.

LPAs discussed infection control practices with administrator Stephanie Baynosa, reviewed food supply, reviewed staff files, and reviewed resident medications. Administrator certificate was observed to be current with # 6050518735 and expire 12/10/2022. Last emergency drill conducted 2/20/22.

LPA toured the kitchen and observed sufficient food supplies of 7 days non- perishables and 2 days perishables. Bedrooms have the required furniture including bedframes, dressers, lamps, and chairs. Beds have the required linen and the linen is in good condition. Passageways and exits are free of obstruction. The backyard are well maintained and has a locked shed for storage. The resident bathrooms are clean, and has the required signs. The hot water temperature measured between 105- 120 degrees F. The facility temperature at the time the visit was comfortable. There is sufficient lighting throughout the facility. LPA observed a sufficient supply of PPE in the hall and in garage. Infection control signs were observed throughout the facility.

Due to technical problems Caretools was not able to open during facility inspection. LPA went over the Caretools questions saved to laptop with Administrator.

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 to administrator Stephanie Baynosa.