Facility Evaluation Report

Licensing Program Analyst (LPA) Andrea Mendivil conducted an unannounced visit for the purpose of conducting a required/ annual visit. LPA was greeted and granted entry into the facility by Caregiver Angela Farro and explained the reason for the visit. Assistant Administrator Yvellete Tantiado arrived at 9:48AM and Administrator Ligaya Garciano arrived at 10:07AM.

At 9:15AM LPA toured the facility with Caregiver Angela Farro .Facility is a 4 bedroom, 2 bathroom, single story home with an attached garage. Facility has 2 clients present during today's visit. LPA observed clients relaxing in their respective bedrooms and facility. Facility appears clean and sanitary. All client rooms had the required elements as well as restrooms stocked with soap/ sanitizer. LPA observed the screening/ sanitizing station in the entrance of the facility. Facility uses a handwritten sign in/ questionnaire. Facility takes client and staff temperatures daily and documents. Facility has covid precaution postings. LPA observed 7 day supply of emergency food and a 24 pack of water. LPA observed locked medication drawer. Facility has a plan for covid testing clients and staff as needed as well as a plan for isolation. LPA observed a 4 week supply of PPE. All staff and clients are vaccinated for Covid-19. LPA reviewed all client files and all contained required documentation including updated emergency information.

Based on the observations made during today's visit, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. This report was discussed and a copy of 809, 809-D, LIC 421BG and appeal rights were provided.