Facility Evaluation Report

Licensing Program Analyst (LPA) Rose Ruppert made an unannounced visit to the facility today to conduct an Annual Required Evaluation. LPA was greeted and granted entry by Jim Fernandez, House Manager. During today’s visit, LPA met with Augustine Au, Assistant Administrator.

The facility is a Level 4i , six bedroom, single story building with an approved fire clearance of six ambulatory clients . The facility currently has a census of five clients i n care.

During today’s visit, LPA toured the facility and inspected the physical plant, including but not limited to testing all smoke detectors, testing hot water temperature in three of three resident bathrooms, and testing auditory devices on all exits . The hot water temperature measured between 116.0 and 127.9 degrees Fahrenheit and all smoke detectors were operational . The fire extinguisher is charged and was serviced on July 26, 2023. The facility’s last fire drill was conducted on June 5, 2024 . LPA inspected the facility food supply and observed the facility retained a minimum of two days perishable and seven days non-perishable food on hand . LPA observed medication storage and reviewed the centrally stored medications. Per review medication appear to be being given as prescribed.

LPA reviewed three of six staff training and fingerprint records . LPA conducted a complete review of client records. Client P&I records were reviewed. LPA interviewed alert residents regarding their quality of care and spoke to staff present regarding care provided. LPA confirmed that administrator has a current administrator certificate which expires on July 29, 2024.

The following deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations (see LIC 809-D). An exit interview was conducted with Augustine Au, Assistant Administrator and a copy of this report was given to the facility along with a copy of the LIC 858, LIC 859; LIC 809-D and Appeal Rights.