Facility Evaluation Report

Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to conduct a health and safety check. LPA was greeted and granted entry by staff. LPA met with Administrator Marjan Arastoo and explained the reason for the visit. LPA and the Administrator toured the facility. LPA observed the facility has their State License posted. LPA observed the fireplace in the dining room has a metal screen. The dining room has 9 tables and numerous chairs and can accommodate all of the clients. The dining room is well lit and no obstacles or hazards were observed. The exit door leading outside from the dining room is operational. LPA and Administrator toured the kitchen. LPA observed a 2 day perishable and 7 day non-perishable food supply on hand. LPA observed a utility sink in the kitchen was leaking from the drain pipe. The kitchen was clean and the stove is operational. LPA observed a staff member preparing for the dinner service. LPA observed the fire extinguisher is fully charged. The exit door leading from the kitchen to the outside of the facility is operational. LPA observed the outside area from the kitchen exit door had old clothes, a clock and some boxes. LPA observed the door to the storage room in the kitchen, next to the ice machine, was missing a door knob. LPA observed there was no activity schedule posted, there was a current monthly menu posted next to the dining room entrance. Administrator reported there are daily activities but no calendar is available. LPA and the Administrator inspected one of the rooms on the first floor. LPA measured the hot water in room 110, it measured 107 degrees Fahrenheit. LPA measured the hot water in the shared restroom on the first floor it measured 112 degrees Fahrenheit. LPA and Administrator toured the second floor of the facility. LPA measured the hot water in second floor shared bathroom, it measured 110 degrees Fahrenheit. LPA observed all the light fixtures are working and all of the fire extinguishers are fully charged. LPA observed furniture and mattresses on the end of the hallway on the second floor. There were 2 mattresses and 2 night stands pushed up against the walls, access was still possible down the middle of the hall. LPA reviewed medication records of 5 clients, no discrepancies noted. LPA reviewed 5 client files. LPA observed that 4 out of 5 clients had a needs and service plan that was 2 years old. Based on the observations made during today's visit, the following violations are being cited per California Code of Regulations, Title 22, Division 6, Chapter 8. An exit interview was conducted and a copy of this report as well as appeal rights were discussed and provided with Administrator