Facility Evaluation Report

Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced health and safety case management visit to the facility. LPA was greeted and granted entry into the facility and explained the reason for the visit.

During the course of the visit, LPA toured the facility and observed the following: Facility is a two story home with caregivers quarters on the second floor. Facility appears clean and sanitary. There is a gated empty pool in the backyard. Water temperature measured at 108.8 degrees F. There is ample two day perishables and seven day non-perishables. LPA observed emergency food and water as well as ample hygiene supplies. Facility provided proof of liability insurance during the visit. Interviews with staff indicate payroll was late 12 days and one out of three staff state being paid full wages. All utilities are operational during today's visit.

Based on observations and interviews conducted, Deficiency is being cited, as per Title 22 Division 6, Chapter 8 of the California Code of Regulations.

An exit interview was conducted with Administrator and a copy of this report as well as appeal rights were provided.