Facility Evaluation Report

Licensing Program Analyst (LPA) Dwayne Mason Jr. made an unannounced visit for the purpose of conducting a Required/Annual Inspection. LPA was greeted and granted entry by Live-In Direct Service Provider Matthew Smith. LPA discussed the purpose of the inspection and Administrator (AD) Marisa Hernandez was contacted by phone. Direct Service Provider Monique Jackson arrived at the facility by 11:30am.

This is a two-story house with six client bedrooms, three bathrooms, and one staff bedroom. All client bedrooms had the required furnishings. LPA observed all client beds had linens and blankets. LPA observed all windows were screened. The back yard has a shaded sitting area. LPA observed one staff and two clients present. Other clients were away at day program. Bathrooms were observed to be free of debris and mildew, faucets and toilets were operational. Water temperature tested over 120 F degrees in client bathrooms. A deficiency is being issued.

LPA observed emergency disaster plan with means of exiting and emergency phone numbers listed and posted at the entrance of the facility. Food menu was also posted and visible. LPA observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food as required by regulations. Smoke detectors and carbon monoxide detectors tested operational. Appliances are operational. Sharps were observed to be locked in the pantry. All and any toxic chemicals, cleaning solutions, laundry toxins and disinfectants are inaccessible to clients. Medication was observed to be locked. The first aid kit has all the required elements. LPA reviewed three client files and three staff files. LPA interviewed two clients and one staff. LPA reviewed P&I and observed two of five clients' P&I to have inconsistencies with the most recent balance on the ledger. A deficiency is being issued.

Based on the observations made during today’s inspection, two 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 was provided.