Facility Evaluation Report
Licensing Program Analyst (LPA) Kimberly Lyman is conducting this unannounced visit for the purpose of completing an annual required inspection. LPA was greeted and granted entry into the facility and explained the reason for the visit.
Facility is licensed for six ambulatory clients and there are six clients currently admitted to the facility. Upon entry, facility appears clean, safe and sanitary.
LPA Lyman along with Care Coordinator Shad Rankiev toured the facility at 7:57 AM. Operations Supervisor Tracy Faust joined the tour in progress. LPA toured the physical plant, checked food service, and reviewed facility documentation. The home consists of two stories with four client bedrooms and two restrooms on the bottom floor and living room, dining room, kitchen, nursing station, multiple therapy rooms and one restroom on the main floor. Client bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each client comfortably. Client bathrooms were checked. Toilets and water faucets worked properly, and shower was free of mold/mildew. Water temperature measured between 111.7 and 113.1 degrees F in facility restrooms. Client bath towels, toiletries and personal hygiene supplies were adequately stocked at time of visit. Common areas were clean and clear of hazards, doorways were free of obstructions. First aid kit had all the required elements. Kitchen was inspected. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. Facility utilizes a chef to come in and prepare lunch and dinner. Clients make their own breakfast. Smoke detectors and carbon monoxide detectors tested operational during today's visit. Fire extinguishers are fully charged. Kitchen appliances are operational during today's visit. LPA toured the outside grounds and observed a fenced jacuzzi with seating for clients. LPA observed ample emergency food and water supply. LPA reviewed the emergency disaster plan during the visit. Plan is thorough and complete. Facility provided documentation of last fire drill conducted on 04/17/2025 and drills are conducted quarterly. CONT ON LIC 809C DATED 06/26/2025
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction