Senior Care Records.

Facility Evaluation Report

Avery Lane, Novato07/25/2023Licence 216804130

Capacity6
Census0
Date signed07/25/2023 01:07:35 PM
The inspector’s account

At approximately 8:30AM, Licensing Program Analyst (LPA) Hansen arrived to conduct a Pre-Licensing visit of this Social Rehabilitation Facility and met with Director, Camille Hildebrand & Anna-Lena Karlsson, Compliance Director. Fire clearance has been approved for 6 ambulatory clients by the Novato Fire Protection District. The facility currently has no clients in care.

LPA conducted a walk-through of the facility and observed the following: Facility is a two-story residence, with 3 bedrooms, 1 bedroom on the main floor and 2 on the second story. There are 3 full bathrooms and 1 half bathroom. There is also a kitchen area, dining room, laundry room, living room, group room, recreation room, and three staff offices. At full capacity, facility will have 2 clients sharing each bedroom.

LPA also observed that the facility was clean and at a comfortable temperature with all exits free from obstruction. Bathrooms were equipped with necessary grab bars, and non-slip mats were present. Bathrooms were supplied with paper towels, liquid hand soap, and hand-washing signs. Hot water temperature checked between 105 degrees F and 120 degrees F in all client’s bathroom faucets as required by Title 22 Regulations. Toxins were secure and inaccessible to clients. There was a sufficient supply of hygiene products, paper products, and linens available for client use. Mattress pads were in place or available for client use.

Facility has an adequate supply of kitchen tools. Per conversation with Director, sharps such as knives will be stored and locked in the facility's pantry room in locked sharps box. Facility will have culinary team that will cook all of the clients food.

LPA observed medication cabinets with lock in the facility's medical office space that will also be locked. Per conversation with Director, client medications will be located here and clients will wait in a designated area when receiving their medication.

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