Facility Evaluation Report

At approximately 9:15AM, Licensing Program Analyst (LPA) Felias arrived unannounced to continue a Required 1 Year visit and met with Staff Member, Iya Pacheco. Team Leader, Chris Speed, arrived during visit at approximately 9:35AM. Facility is an Adult Residential Home that provides care and assistance for Adults with Mental Health Diagnoses. Facility has an approved fire clearance for 10 Ambulatory Clients with a total capacity for 10 Clients. Upon arrival, LPA was informed that there were 10 clients in care and 1 staff member on-site.

At approximately 9:25PM, LPA reviewed the Facility's Staff Roster and found that all staff on-site were background cleared and associated to the facility per regulation. At approximately 9:50AM, LPA reviewed a sample size of 6 Client files which were found to be well organized, thorough and contained the required documentation. Facility does not assist clients with P&I monies at this time.

At approximately 11:50AM, LPA reviewed a sample size of 6 staff files. Review of staff files indicated that 6 of 6 staff files did not have current First Aid/CPR certificates. Per Title 22 Regulations, staff providing direct care and supervision shall receive First Aid training from qualified agencies (See Deficiency Page, Regulation 80075(f)).

At approximately 12:30PM, LPA reviewed a sample size of 6 Client Medication Records. Records were observed to be centrally stored and secure.

At approximately 1:20PM, LPA conducted staff interviews.

LPA conducted a walk through of the facility. Carbon Monoxide Detectors were tested and operational. LPA observed that the facility does not have a evacuation chair at this time. Team Leader understands that an evacuation chair needs to be on-site to remain compliant with Health and Safety Code (See Technical Advisory 1565(f)(1).

LPA observed that there is a locked fridge located in the facility kitchen as well as signs indicating that foods is only available at certain times (pictures taken).