Facility Evaluation Report

Licensing Program Analyst (LPA) Sarah Hurt conducted an unannounced visit today for the facility’s annual inspection. LPA met with Licensee, Mila Green Continual Administrator's Certification expires 12/16/23. There are currently 4 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. Bedrooms were clean and in good repair. 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. Water temperature was tested at 107 degrees. Toxins and cleaning supplies are locked and inaccessible.

LPA observed the water pressure in the hallway sink on the first floor is very low. LPA observed the facilities Emergency Disaster Plan (LIC610D) is not current. LPA observed expired food inside the facility refrigerator, and several boxes of expired food in the garage. LPA observed a small hole in one of the window screens in the back of the house. LPA observed facility trash bins with no lid.

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 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 Licensee Mila Green, and copy of report left at facility