Facility Evaluation Report

Licensing Program Analyst (LPA) Sarah Hurt conducted an unannounced visit today for the facility’s annual inspection. LPA met with Regional Director, Jessica Greco, and Program Director Nancy Fregoso. There are currently 44 clients receiving services at this facility location. LPA inspected the interior and the exterior of the facility including the common spaces, bathrooms, activity rooms, kitchen, and outdoor areas.

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. Water temperature was tested at 107 degrees. First Aid kit is on site and complete. Toxins and cleaning supplies are locked and inaccessible. LPA reviewed 5 facility client, and 5 facility staff files, Infection Control Plan, Emergency Disaster Plan, and Plan of Operation.

There were no 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 Regional Director, Jessica Greco, and Program Director Nancy Fregoso and copy of report left at facility