Facility Evaluation Report

Licensing Program Analysts (LPAs) Joseph Alejandre and Edward Kim made an unannounced visit to conduct the required annual inspection. LPAs were greeted and granted entry by staff. LPAs explained the reason for the visit. LPAs met with house manager Miriam Esquivel. LPAs and house manager toured the facility. Facility is a 9-bedroom, 4-bathroom, two-story house with an attached garage that is being used for storage. Lacy Faddoul's Administrator's Certificate expires on May 9, 2024. LPAs observed the See Something, Say Something poster (PUB 475) posted in entrance of the facility. Smoke detectors/carbon monoxide detectors tested operational. The fire extinguisher mounted next to the kitchen is fully charged. LPAs observed the kitchen is clean and organized. The stove lights unassisted. LPAs observed the knives are kept locked and inaccessible to residents. LPAs observed the medication is kept locked in a kitchen drawer. LPAs observed a 2 day perishable and 7 day non-perishable food supply on hand in the kitchen. LPAs observed all 4 bathrooms are clean and operational. Hot water measured between 108.1 and 111.3 degrees Fahrenheit. LPAs toured the resident rooms. All resident rooms had the required furnishings and linens. LPAs and the house manager toured the backyard and garage. The garage is kept locked and used for storage. LPAs observed a shaded seating area for residents to sit outside. LPAs observed the exit gate door knob was broken and non-operational. No bodies of water observed in the backyard. LPAs reviewed 4 out of 5 staff files. 4 out of 5 staff have not completed the required 20 hours of annual training. All 4 staff have completed CPR/First-Aid training. LPAs reviewed resident files. 2 out of 12 residents were missing a current reappraisal. LPAs reviewed resident medications. 1 out of 12 residents did not have all of their medications at the facility. Resident 2 was missing their Chest congestion relief DM SYR liquid which was not at the facility. Based on the observations made during today’s inspection, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted and a copy of this report and appeal rights was discussed with and provided to facility representative.