Facility Evaluation Report

Licensing Program Analyst (LPA) Dwayne Mason Jr. arrived at the facility to conduct an unannounced Required 1-Year Inspection. LPA was greeted and granted entry by Licensee Elizabeth Maldonado

The facility is a one-story home with three client bedrooms, two bathrooms, living room, dining room, kitchen, laundry room, staff room/bathroom, backyard and attached two car garage. Facility fire extinguishers were observed to be fully charged and serviced on 1/9/24 per the service tags. LPA did not observe any hazards or obstacles throughout the facility. Bedrooms had the necessary furnishings. LPA observed two rooms to be vacant. Hot water in both bathrooms measured at 110 degrees Fahrenheit and 105 degrees Fahrenheit. LPA issued a Technical Assistance advising Licensee to maintain water log. All and any toxic chemicals, cleaning solutions, laundry toxins and disinfectants are inaccessible to clients and will be stored and locked in the garage. Medication is locked in a cabinet in the hallway. Files are stored in the workstation near the living room and kitchen. LPA reviewed two of two client files, medication and P&I. Clients were observed to be away from the facility at day program and with family. LPA reviewed four staff files. Based on file review, LPA determined facility has been conducting disaster drills twice a year as opposed to quarterly. A deficiency is being issued on this day. Smoke and carbon monoxide detector tested operational.

LPA issued three Technical Violations for the following Regulations: Infection Control 85095.5(c), Personnel Records - Training 80066(a)(10) and Safeguards for Cash Resources, Personal Property and Valuables of Residents 80026(h)(1)(A) & 80026(h)(1)(B).

Based on the observations made during today's visit, one deficiency is being cited as per Title 22 Division 6 Chapter 2 of the California Code of Regulations. An exit interview was conducted with Licensee Elizabeth Maldonado, and a copy of this report, deficiency page, LIC9102s and appeal rights were provided.