Facility Evaluation Report

Licensing Program Analyst (LPA) Sarah Hurt conducted an unannounced visit today for the facility’s annual inspection. LPA met with Facility staff Kevin Plunkett, Continual Administrator's Certification for Licensee Dilcia Ward expires 02/25/2028. There are currently 5 residents who reside at this home. LPA inspected the interior and the exterior of the facility including the common living spaces, resident bedrooms and bathrooms, activity rooms, medication storage, kitchen, garage and outdoor areas. There is a locked storage for medications. Food supply is adequate for 2-day perishable and 7-day nonperishable.

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.

The facility has multiple mirrors, and wall decor that are extremely dusty. The facilities Infection Control Plan is not acknowledged as reviewed annually. The resident hallway bathroom sink water measures to be 133 degrees. LPA observed multiple cans of disinfectant spray in facility hallway, unlocked and accessible to residents.

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 610D 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 over the phone with Facility staff, Kevin Plunkett, and a copy of report provided..