Facility Evaluation Report

Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to conduct the required annual inspection. LPA met with Administrator Rhodora Gulland and explained the reason for the visit. The Administrator's certificate expires on June 23, 2026. Facility is a one story house with Facility has 5 bedrooms and 2 bathrooms. 3 bedrooms are for residents, living room with a screened fireplace, kitchen, dining room and a two car garage. Facility is licensed for 6 non-ambulatory residents with a hospice waiver for 2. LPA and the Administrator toured the facility. LPA observed the See Something, Say Something poster (PUB 475) posted in the entry way. The kitchen is clean and organized. LPA observed a 2 day perishable and a 7 day non-perishable supply of food in the kitchen. The fire extinguisher in the kitchen is fully charged. Knives are kept locked in a kitchen drawer. Medications are kept locked in a tool box kept in the kitchen. LPA observed all cleaning supplies are kept locked in the laundry room. LPA observed all resident rooms had the required furnishings. LPA observed both bathrooms are clean and operational. Hot water measured 120.0 degrees Fahrenheit. The garage is kept locked and used for storage. LPA observed a 3 day emergency supply of food and water stored in the garage. Smoke detectors/carbon monoxide detectors tested operational. There is no record of a emergency disaster drill being conducted in the last quarter. Facility has internet and a smart phone that is dedicated for resident use. LPA inspected the first aid kit. The first aid kit has all the required elements. LPA reviewed 1 resident record and medication, no discrepancies observed. LPA reviewed 2 staff files, no discrepancies observed. Both staff members are background cleared and associated to the facility. LPA and Administrator toured the backyard. No bodies of water observed. There is a table and chairs with an umbrella for residents to sit outside. Both exit gates are operational. No obstacles or hazards observed in the backyard. Deficiencies are being cited per Title 22, Division 6 of the California Code of Regulations (CCR). An exit interview was conducted and a copy of the report along with appeal rights was provided.