Facility Evaluation Report

Licensing Program Analyst (LPA) Ruth Martinez conducted an unannounced visit for the purpose of conducting a required annual inspection. LPA was greeted and granted entry into the facility by caregiver. LPA spoke to Brandon Penalosa, Administrator via telephone and explained the nature of the visit.

LPA accompanied by caregiver began the tour of the inside and outside of the facility. There are four clients in care and there is no active Covid-19 case in the facility. LPA observed two clients in living room and remainder of clients in their bedrooms. All clients appeared to be clean and well taken care of. LPA observed required department postings, covid-19 precautionary postings in the facility as well as hand washing signs throughout the facility. All restrooms observed to have a supply of soap and appeared to be clean. LPA inspected client’s bedrooms and appeared to be clean and sanitary. All bedrooms observed to have all required components. Client’s bedrooms are all private bedrooms with one client per. LPA was checked in upon entry per Covid guidelines. Facility is taking temperature daily and documenting the results. LPA observed the emergency disaster and evacuation plan. Facility has the back-up emergency food and water supply as well as PPE supplies. LPA toured the outside of the facility and observed a shaded seating area for client’s enjoyment. The facility has completed the LIC808 Mitigation Plan, LPA reviewed and approved the plan on today’s visit. LPA emailed the signed and approved plan to the Administrator for their records.

Based on the observation made during today’s visit, no deficiencies were noted today per Title 22 Division 6 of the California Code of Regulations.

This report was reviewed with the facility representative and a copy of this report was provided to the facility.