Facility Evaluation Report

Licensing Program Analyst (LPA) Dwayne Mason Jr. arrived for an unannounced visit for the purpose of conducting a required annual inspection. LPA was greeted and granted entry by DSP Susan Cobrado. Administrator Buja Chang joined the inspection during the tour.

The facility is a one-story home with four resident bedrooms, three bathrooms, kitchen, dining room, living room, family room, staff room, back yard and attached two-car garage. Facility appeared clean, sanitary and well-organized. All resident rooms had required elements, including bed, chair, closet space and ample lighting. Restrooms are stocked with soap and paper towels. Hot water measured at 109.6 degrees Fahrenheit in the bathroom nearest to the front door, 116.6 degrees Fahrenheit in the bathroom located inside of one of the room nearest the front of the house and 117.8 degrees Fahrenheit in the bathroom nearest to the back of the house. Facility has a supply of extra linen stored in the hallway. LPA observed exit gate in the backyard to be operational and unobstructed. Facility has two shaded seating areas in the backyard and one shaded seating area in the front yard. Smoke and Carbon Monoxide detectors tested operational. LPA observed facility has emergency food and water supply. Laundry machines are stored in the garage and operational. Fire Extinguisher was observed to be fully charged as indicated by the built-in meter. The service tag indicates it was last serviced on 12/06/22. LPA reviewed medication and files for two out of the four clients. LPA reviewed three staff files. Medication and files are stored in a locked cabinet in the dining room. All residents were away at day program at the time of inspection.

No deficiencies were noted during today's visit. An exit interview was conducted and a copy of this report was provided to the administrator.