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Facility Evaluation Report

Olive House, Novato07/01/2025Licence 216803486

Capacity4
Census4
Date signed07/01/2025 03:59:25 PM
Name of licensing program analystShannan Hansen
Name of licensing program managerBethany Moellers
The inspector’s account

Licensing Program Analyst (LPA) Hansen arrived unannounced at approximately 12:30 PM to conduct an Annual Required inspection and was greeted by Administrator, Jacques "Phil" Scutt. 4 Clients were present during the visit. There is no day program at this time due to short staffing for one on one care for clients at Adult Day Program. Facility is a single-story Adult Residential Facility with 3 client bedrooms, 2 bathrooms, a kitchen, living room, dinning room & office in garage. Novato Fire Department has provided clearance for 4 Ambulatory clients.

During facility tour on 7/1/2025 with licensee/administrator Jacques Scutt, facility was found to be clean and at a comfortable temperature with all exits free from obstruction. Required postings were observed. Sample of client’s bedrooms, common areas, kitchen & food storage areas were inspected. Fire Extinguisher was found to be last charged on 03/19/2025 at the time of the visit. Carbon monoxide detector and smoke detectors test was conducted and were operational during this visit. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. Food stored in refrigerator were properly stored as per regulations on this day at the time of the visit. Toxins are stored locked in garage cabinets. LPA observed that dangerous items were locked. There was a supply of cleaners, hygiene products and paper products available for clients. Sample of client’s bedrooms were inspected and had lighting & appropriate furnishings; mattress pads are available for clients at the facility. Facility hot water temperature in clients' bathroom faucet measured 118.7 degrees F in 1 out of 1 faucet within Title 22 acceptable regulations of 105 to 120 degrees F. Disaster Drills have been conducted quarterly and last dated 2/20/2025.

LPA initiated a file review at 1:00 pm. Four clients and four staff files were reviewed. Clients records have updated care plans on file. First aid certificates for staff are current. Administrator Certificate for Jacques Scutt 7003045735, expires 10/24/2025. Medications and medication records were reviewed. P & I monies/Cash resources documentation were reviewed and not comingled. Continued on LIC809-C

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