Facility Evaluation Report
Licensing Program Analyst (LPA) Dwayne Mason Jr. made an announced inspection to the facility for purpose of conducting a pre-licensing inspection. LPA arrived at the facility at 9:05am and was greeted and granted entry by designated Administrator (AD) Annette Winters. An application to operate a Residential Care Facility for Elderly (RCFE) for (6) capacity, (0) ambulatory, (6) non-ambulatory, and (0) bedridden clients was received by Community Care Licensing (CCL) on 3/22/2023.
Structure: The facility is a one-story home with three resident bedrooms, two bathrooms, living room, kitchen, dining room, family room, an attached two car garage, backyard, porch and a crawl-space accessible through a pull-down ladder in the hallway. Photos of the pull-down ladder leading to the crawl-space were taken. LPA observed the crawl-space to be empty. LPA observed the See Something, Say Something poster (PUB 475) in the facility mounted on the wall in one of the living room. There is a back yard with one exit gate on Northeast side of the house. There is one shaded seating area in the backyard. LPA did not observe any obstacles or hazards in the backyard. LPA observed a hole in one of the garage windows facing the backyard. Applicant must replace this window by the assigned due date in order to be ready for licensing.
Client Bedrooms: All resident bedrooms had the required furnishings. LPAs observed all resident beds had linens and blankets. LPA observed all windows were screened. LPA observed closet doors in all resident rooms to be inoperable. The applicant will replace all closet doors by the assigned due date in order to be ready for licensing.
Toxins: LPA observed chemicals, cleaning solutions, laundry toxins and disinfectants are inaccessible to client and will be stored and locked in closet in the hallway.
Medications, First-Aid Kit & Book: Medication will be stored in a locked closet in the hallway. First aid kit is stored in the same locked closet. The first aid kit has all the required elements.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction