Facility Evaluation Report

Licensing Program Analyst (LPA) Dwayne Mason Jr. conducted an unannounced annual required visit. LPA arrived at the facility and was greeted by Administrator Mario Antonio and explained the nature of the visit. The facility is a one-story home with three client rooms, one client bathroom, one staff room, one staff bathroom, office, kitchen, dining room, living room, backyard with covered patio, laundry area and 2-car garage.

LPA observed the facility to be clean safe and sanitary in most rooms. Upon entry into the facility, LPA observed an excess of furniture (couches, shelves, tables) moved to the center of the living room and unused items in the backyard (bed frame, cardboard boxes) creating a potentially unsafe area for clients. A deficiency is being issued. All client rooms had the required elements, including bed, chair, closet space and ample lighting. Facility has extra linens and hygiene supplies for residents in hallway cabinets. Restrooms are stocked with soap and paper towels. Hot water measured below 105 degrees F. A deficiency is being issued. LPA observed emergency food and water supply. LPA observed the fire extinguisher was serviced on 9/3/2024. Smoke/Carbon Monoxide detector were tested and noted as operational. LPA observed hazardous items such as knives, chemicals and cleaners to be locked up in the laundry area and garage. Medication for each resident is kept locked in a cabinet in the kitchen. Exit gate is unlocked and self-latching. LPA observed exit gates to be unobstructed. LPA reviewed all three client files. Client files contained all the necessary elements. LPA reviewed two staff files. LPA observed no health screenings in the staff files. A Technical Violation (TV) is being issued. Based on record review, LPA observed the facility does not have the following: an infection control plan, a completed emergency disaster plan or record of 4 quarterly drills within the last year. Three deficiencies are being issued. LPA also reviewed P&I and medication for three clients.

Based on the observation made during today’s visit, five deficiencies and a technical violation are being issued per Title 22 Division 6 of the California Code of Regulations. This report was reviewed with facility staff and a copy was provided to the facility.