Facility Evaluation Report

Licensing Program Analyst (LPA) Sarah Hurt conducted an unannounced visit today for the facility’s annual inspection. LPA met with Program Director Katherine Coleman. There are currently 107 clients receiving services at this facility. LPA inspected the interior and the exterior of the facility including the common spaces and bathrooms, activity rooms, medication storage, kitchen, and outdoor areas. There is a locked storage for medications.

Fire extinguisher is within the safety regulation period. Smoke alarms were tested and are operational. The home has a carbon monoxide detector and performs disaster drills as required. First Aid kit is on site and complete. LPA reviewed facilities Emergency Disaster Plan, Infection Control Plan, Disaster Drills, and Plan of Operation.

LPA observed facility kitchen water temperature was tested at 128 degrees. LPA observed toxins and cleaning supplies accessible to residents. Resident 1 does not have medical assessment or Needs and Services plan in file. Resident 2 does not have updated Needs and Services plan in file. Facility staff files are not complete, and several are missing applications.

The following deficiencies observed or cited during today's inspection per California Code of Regulations, Title 22.

LPA requested the following documents: LIC 500 Personnel Report, LIC 308 Designation of Administrative Responsibility, LIC 610-E the Emergency Disaster Plan and copy of current Administrator’s Certificate to update the facility file. Listed documents shall be sent to Licensing.

Exit interview conducted with Program Director Katherine Coleman and copy of report left at facility