Facility Evaluation Report

On this day Licensing Program Analyst (LPA) Andrea Mendivil made an unannounced visit to conduct a required annual visit. LPA was greeted and granted entry into the facility by Lead Staff Victor Capada. Administrator (AD) Placida De la Cruz arrived shortly after.

The facility is a single story home with four resident bedrooms, two bathrooms, kitchen, dining room, living room, lounge/staff office, staff room, backyard and attached 2-car garage. LPA Mendivil observed 3 clients in the facility, the remaining 3 clients are at day program. Facility appears clean and sanitary. All clients rooms had required elements, including bed, chair, closet space and ample lighting. Facility has extra linens in the hallway closet and the garage. LPA Mendivil tested hot water temperatures in both bathrooms and they read between 106.7 degrees and 109 degrees. LPA observed medications in locked cabinet in the kitchen. LPA observed facility has emergency food and water supply. LPA observed hazardous items such as knives, chemicals and cleaners to be locked up. Knives and sharps are locked in drawers in the kitchen, chemicals are locked separately in the garage. Exit gates are unlocked and the paths leading to them were observed to be unobstructed. LPA reviewed six of the six client files, two of the six client medication, six of six P&I records. All client files have the required documentation. LPA Mendivil reviewed four of four staff documents, per review 3 staff do not have record of TB test results. Two of the four staff do not have a signed medical assessment indicating they are in good health.

Therefore based on observations made decifiencies are being cited per California Code of Regulations Title 22. An exit interview was conducted and a copy of this report,appeal rights and LIC 858 was provided.