Facility Evaluation Report

At approximately 9:15AM, Licensing Program Analysts (LPAs) Felias and Loera arrived unannounced to conduct a Required 1 Year visit and met with Staff Member, Laurie Kreger. Staff Members, John Coleman and Charles Boomer, arrived during visit at approximately 9:50AM. Team Leader, Zasha Deaep, arrived during visit at approximately 10:15AM. Assistant Program Director, Suhay Rivas was unavailable during visit. Facility is an Adult Residential Home that provides care and assistance for Adults with Mental Health Diagnoses. Facility has an approved fire clearance and capacity for 10 Ambulatory Clients. Upon arrival, LPAs were informed that there were 7 clients in care and 1 staff member on-site.

At approximately 9:35AM, LPAs 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 10:00AM, LPAs conducted a walk-though of the facility with Staff Members. LPAs observed the following: The facility was found to be clean and at a comfortable temperature with all exits free from obstruction. Facility had emergency lighting. Facility is a 3 story building with 5 Client bedrooms, 4 bathrooms, 1 staff room, 2 staff offices, and common spaces. Facility has Infection Control Plan on file. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. Toxins were observed to be stored inaccessible to clients. There was an appropriate supply of cleaning products, linens, hygiene products and paper products available for clients. Mattress pads were in place or available for client use. Hot water temperatures for all sinks in facility were within Title 22 regulations of 105 to 120 degrees Fahrenheit.

LPAs reviewed client files. Administrator's Certificate for John Ahrens is current with an expiration date of 07/16/2025.

Fire extinguishers were last inspected May 2024. Smoke detectors and carbon monoxide detectors were tested and operational. Facility's last emergency disaster drill was conducted June 2024.

LPAs unable to complete the Annual Inspection. Annual Continuation Visit to be conducted at a later date.

Exit interview conducted. Copy of report discussed and provided to Team . Signature on form confirms receipt of documents.