Facility Evaluation Report

Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to conduct the required annual inspection. LPA was greeted and granted entry by staff. LPA explained the reason for the visit. Facility is a single story home with 7 bedrooms, 5 bathrooms, living room, activity room, dining room, kitchen and a 2 car garage. Facility is licensed for 6 non-ambulatory residents of which 1 can be bedridden and a hospice waiver for 5. LPA and staff toured the facility. LPA observed the See Something, Say Something poster posted in the main entry way of the facility. LPA observed all resident rooms had the required furnishings. LPA observed all bathrooms are clean and operational. Hot water measured 118.6 degrees Fahrenheit in the shared bathroom in the hallway. The fire extinguisher in the kitchen is fully charged. LPA observed a 2 day perishable and a 7 day non-perishable food supply on hand in the kitchen. Knives are kept locked in a kitchen drawer. Soaps and cleaning supplies are kept locked under the kitchen sink. LPA observed the 5 burner gas stove lights unassisted. Medications are kept locked in the hall closet. LPA observed clean linens are stored in the pantry in the hallway. The garage is kept locked and used for storage. Smoke detectors/carbon monoxide detectors tested operational. The last emergency drill took place on April 15, 2025. LPA and staff toured the backyard. No bodies of water observed. There is a shaded seating area in the backyard. Both exit gates are operational. No obstacles or hazards observed in the backyard. LPA and staff toured the garage. The garage is kept locked and used for storage. LPA observed a 3 day emergency food and water supply in the garage. LPA reviewed 4 resident records and medications, no discrepancies observed. LPA reviewed 4 staff files. LPA observed Staff 3 and Staff 4 did not have completed health screening, no other discrepancies observed. All staff present at the facility are background cleared and associated to the facility. Deficiencies are being cited per Title 22, Division 6 of the California Code of Regulations. An exit interview was conducted and a copy of the report provided along with appeal rights.