Facility Evaluation Report

Licensing Program Analyst (LPA) Sarah Hurt conducted an unannounced visit today for the facility’s annual inspection. LPA met with facility staff Janna Suglian Continual Administrator's Certification for Shana Thrasher expires 08/19/2027. There are currently 5 residents who reside at this home and there is 0 residents on hospice at this time. LPA inspected the interior and the exterior of the facility including the common living spaces, resident bedrooms and bathrooms, activity rooms, medication storage, kitchen, and outdoor areas. There is a locked storage for medications. Food supply is adequate for 2-day perishable and 7-day nonperishable.

Fire extinguisher is within the safety regulation period. Water temperature was tested at 113 degrees. Toxins and cleaning supplies are locked and inaccessible.

LPA observed two facility resident bedrooms smell strongly of urine. LPA observed facility front room carpet to be stained. LPA observed downstairs bedroom labeled on facility sketch as resident bedroom is full of mattresses and clutter. LPA observed rotten molded cabbage in the facility refrigerator. LPA observed back porch slider window screen has tear near the door handle.

The following deficiencies observed or cited during today's inspection per California Code of Regulations, Title 22.

LPA will return at a later date to review records and complete this inspection.

LPA requested the following documents: LIC 500 Personnel Report, LIC 308 Designation of Administrative Responsibility, LIC 610-E the Emergency Disaster Plan and copy of current Administrator’s Certificate to update the facility file. Listed documents shall be sent to Licensing.

Exit interview conducted with Facility staff, Janna Suglian, and copy of report left at facility