Facility Evaluation Report

Licensing Program Analyst (LPA) Kimberly Ramirez conducted an unannounced annual visit using the Infection Control Evaluation Tool. LPA met with Administrator Sandra Bote and explained the reason for the visit. Physical Plant was toured, sample record of medications were reviewed, and food supply was inspected.

LPA and Administrator toured the home and inspected (3) client bedrooms, (3) bathrooms, kitchen, den, dining room, living room, side patio, and detached garage. The front and backyard are well maintained and there are no pools or large bodies of water. There is a shaded seating area for the clients located in the side patio. Passageways and exits are free of obstruction. The facility is licensed for clients 18-59 years old. However, there are 4 clients over the age of 60, which exceeds 50% of census. The licensee must request an exception in order to accept or retain the individual. Licensee Jessica Montesinos, indicated she has correspondence from another LPA indicating an Age Exception Waiver is/was no longer required. If acceptance or retention of an individual 60 years of age or older would result in the number of persons 60 years of age or older exceeding 50% of the census in facilities with a capacity of six or fewer clients, or 25% of the census in facilities with a capacity over six, the licensee must request an exception in order to accept or retain the individual. The documentation specified in Section 85068.4(c) must be submitted with the exception request. LPA Ramirez will grant the licensee 4 business days (11-18-22) from 11-15-22 to provide proof of correspondence. Administrator certificate expires on 03-10-2023.