Facility Evaluation Report

Licensing Program Analyst (LPA) Dwayne Mason Jr. arrived at the facility unannounced for the purpose of

conducting a required annual inspection. LPA was greeted and granted entry into facility by DSPs Maricar Gil and Faye Garcia. Office Manager Laura Aquino joined the inspection approximately five minutes after LPA's arrival.

The facility is a one-story home with four client bedrooms, three bathrooms, kitchen, dining room, living room, staff room and two attached 1-car garages. Facility appears clean, safe and sanitary. All client rooms had required elements, including bed, chair, closet space and ample lighting. Facility has extra linens for clients in the hallway closet. Restrooms are stocked with soap and paper towels and have hand washing postings. Hot water measured at 120 degrees Fahrenheit. LPA advised facility staff to maintain a water log since the temperatures are close to the threshold. LPA observed facility has emergency food and water supply. LPA noted Fire Extinguishers were last serviced on 5/22/2023. LPA observed hazardous items such as knives, chemicals and cleaners to be locked up in cabinets in the kitchen. Knives are locked up separate from toxic chemicals. Medication for each resident is kept locked in a cabinet in the hallway. Exit gates are unlocked and unobstructed. LPA reviewed three of the five client files and three staff files. LPA also reviewed medication for two clients and P&I for three clients. Based on record review, LPA noted errors in the medication administration record on 2/26/2024 and 2/27/2024. A technical assistance was issued.

No deficiencies were issued based on today's inspection. An exit interview was conducted and a copy of this report was provided to the facility