Facility Evaluation Report

Licensing Program Analyst (LPA) Rose Ruppert and Licensing Program Manager (LPM) Alisa Ortiz made an unannounced visit to the facility today to conduct an Annual Random/Required Evaluation. LPA and LPM were greeted and granted entry by Jiyasmine Coruna, House Manager. During today’s visit, LPA & LPM met with Theodora Fredericksen, Administrator .

The facility is a single story building with an approved fire clearance of six non-ambulatory residents . The facility currently has a census of six clients in care.

During today’s visit, LPA and LPM toured the facility and inspected the physical plant, including but not limited to testing all smoke detectors and testing hot water temperatures in four resident bathrooms. The hot water temperature measured between 106.1 and 107.7 degrees F and all smoke detectors were operational . The facility’s last fire drill was conducted on March 17, 2024 . LPA and LPM inspected the facility food supply and observed the facility retained a minimum of two days perishable and seven days non-perishable food on hand . LPA and LPM observed medication storage and reviewed the centrally stored medications. Per review completed medication appear to be being given as prescribed.

LPA and LPM reviewed four staff training and fingerprint records and conducted a complete review of client records. LPA and LPM interviewed six clients regarding their quality of care and spoke to staff present regarding care provided. LPA and LPM confirmed that administrator has a current administrator certificate.

Based on the observations made during today’s visit, the facility appears to be in compliance with Title 22 Division 6 of the California Code of Regulations, no deficiency cited on this date. An exit interview was conducted with Theodora Fredericksen and a copy of this report, client and staff confidential names list and LIC 9102s were given at the time of the visit.