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 Rita Faatuai. There are currently 55 clients receiving services at this location. LPA inspected the interior and the exterior of the facility including the common spaces, activity rooms, kitchen, and outdoor areas. Facility is clean and in good repair.

Fire extinguisher is within the safety regulation period. The facility performs disaster drills as required. Water temperature was tested at 106 degrees. First Aid kit is on site and complete. Toxins and cleaning supplies are locked and inaccessible.

LPA observed the facilities Personnel files do not have all required documentation. Staff 1 does not have Health screening inside personnel record. LPA observed the facilities Emergency Disaster plan does not have all required information. LPA observed the facilities Infection Control Plan has not been reviewed annually and does not have details of Infection Control Lead training.

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 Rita Faatuai. and copy of report left at facility