Facility Evaluation Report

At approximately 12:20 PM, Licensing Program Analyst (LPA) Magdaleno arrived unannounced to conduct a required 1-year annual inspection. Administrator Wei "Willie" Yang and House Manager Jocelyn Farreau arrived at approximately 12:35 PM. Staff Jenny Qian from Caremax, inc Administration office arrived shortly after. Facility is an Adult Residential Facility (ARF) with three (3) clients in care. LPA was informed that all clients were away at Day Program. Facility is serviced by vendor Golden Gate Regional Center (GGRC).

At approximately 12:40 PM, LPA initiated a tour of the facility with Administrator and observed the following: Facility is a two (2) story home, was a comfortable temperature, and passageways were free from obstructions. LPA was informed that second story is used for staff rooms and not accessible to clients. Facility's fire extinguisher was observed charged and last serviced 10/25. Smoke and Carbon Monoxide detectors were tested and operational during inspection. Water temperatures in client bathrooms read at 105.3 degrees F and 108.5 degrees F which is within the allowable range of 105 to 120 degrees F per Title 22 regulations. LPA observed a supply of clean linens, hygiene, and paper products available for clients. Clients' bedrooms were inspected and observed to have all the appropriate furnishings as outlined in Title 22 regulation.

Cabinets containing cleaning supplies and other items that could pose a risk were locked. Facility has at least two (2) days of perishable food and seven (7) days of non-perishable foods, as well as an emergency water supply. Facility has an internet access devise and internet available to clients in care, and the phone was tested and operational during today's inspection. There is a shaded seating area in the backyard with outdoor space for activities. Facility stores additional supplies including emergency food and seasonal decorations in outer room.