Facility Evaluation Report

Licensing Program Analyst (LPA) Shannan Hansen arrived unannounced to conduct an Annual inspection of facility and was welcomed by staff Yardly (NOC) and Lanisa who contacted House Manger and Administrator who arrived during visit. Facility is a 2 story building with all 5 bedrooms, three bathrooms, & communal areas on top floor that is adjacent to driveway. Bottom floor is office space, bathroom, kitchenette, overflow food & storage room, and garage. Facility granted fire clearance by Marin County Fire Department for 5 client bedrooms 1 of which may be Non-ambulatory. During today’s inspection facility has 5 clients although one is still at skilled nursing facility from injury.

LPA and staff initiated a tour of the facility at approximately 8:55am and made the following observations: Facility was a comfortable temperature and passageways were free from obstructions. Client rooms were furnished per regulation; although House Manager informed C1 does not have a chair as they use it as a weapon. Water temperature in sinks accessible to clients measured at 115 and 118.5 degrees F within regulations of 105 to 120 degrees F in 2 of 2 client bathrooms tested. Extra hygiene products and linens were available. Cleaning supplies and disinfectants are stored in upstairs closet next to washer & dryer that at approximately 9:10am on 10/9/2025 was observed to be unlocked containing; comet w/ bleach, Easy Off Heavy duty oven cleaner, 2- 64 oz kingsford charcoal lighter fluid, large container of Clorox cleaner + bleach, and gallon of cloralen bleach “High performance bleach for commercial use/home use and other cleaning supplies (see pics & LIC 809-D). Also observed by staff & LPA in downstairs garage overflow storage closet (with sign this door to remain locked at all times) hand lock does not always lock, contained 2 five gallon buckets of paint and smaller paint cans, cabinets with signage for additional cleaning supplies, additional freezers and food and emergency food supplies, which are not to be stored in same space (see pics & LIC 809-D) toxins moved to locked storage shed prior to end of visit.). Continue on LIC809C