Facility Evaluation Report

On today's date, Licensing Program Analysts (LPAs) Rosie Quiroz and Michael Tea conducted an unannounced Annual Required-1 year inspection visit. LPAs were granted entry by Live in House Manager (HM) Susan Gonzales. LPA Quiroz called Administrator (AD) Nadine Rojas to inform her about LPA's unannounced visit.

AD Nadine Rojas reported being on premises more than 20 hours per week. AD Certificate for Nadine Rojas expires on 2/22/2025.

This is a leveI 3 Facility licensed for a capacity of six clients, (6) Ambulatory clients providing services to Adult clients with Developmental Disabilities ages 18-59. At 9:09am, LPA Quiroz reviewed whether the following is in compliance: licensee is operating the facility within the conditions and limitations, which are specified on the license, including the capacity limitation.

The facility is a 1 story home. The home consists of: 3 client shared bedrooms, 3 restrooms for clients and staff , living room, kitchen with dining area, activity room, 1 staff office/lounge room, 2 car garage and back yard with gated and secured swimming pool. HM reported, "The clients don't really use the pool." Two secured/ locked sheds observed in back yard area.

Between 8:55am-9:40am, LPAs reviewed 4 of 4 staff records, 4 of 4 client records and 4 of 4 Personal & Incidental funds records (P&I). Staff records, clients records and P&I funds were found to be within Title 22 California Code of Regulations (CCR).

At 9:42am, LPAs reviewed 4 of 4 client centrally stored medication records. LPAs observed medications are secured in a secured cabinet in dining area, not accessible to clients in care. 4 of 4 Medication records were found to be within Title 22 CCR.

At 9:55am, LPAs along with HM Gonzales conducted the tour inspection. A tour of the interior and exterior of the facility and physical plant were inspected, including but not limited to testing hot water temperature in resident and common bathrooms. The resident bathroom water tested and measured between 104.9- 105.8 degrees Fahrenheit. All smoke detectors, carbon monoxide, were operational and functional.