Facility Evaluation Report

Licensing Program Analysts (LPAs) Kimberly Lyman and Jerome Haley made an unannounced plan of correction visit to follow up on citations issued on 10/26/2021. LPAs were greeted and granted entry into the facility by Caregiver Michelle Pasha and explained the reason for the visit. House Manager Christy Valerio arrived during the visit.

At 2:45 PM, LPAs toured the facility and observed the following:

*Deficiency cited under Title 22 Regulation 87705(f)(2) pertaining to inaccessible items has been cleared. All noted items have been secured. Licensee has complied with the terms of the POC.

*Deficiency cited under Title 22 Regulation 87468.1(a)(2) pertaining to personal rights has been cleared. Facility has all posted signage during today's visit. Licensee has complied with the terms of the POC.

Advisory note dated 10/26/2021 advised the following:

Facility to remove eye drops from resident's room. Eye drops have been removed.

Facility fountain is full of green water and unsecured. Please secure fountain and ensure water is clean. Fountain is secured and clean during today's visit.

Tiles on the ground in side yard are loose and presenting a fall hazard. Please remove or secure tiles. Facility has not addressed issue to date.

Based on the observations made during today's visit, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. This report was discussed with the facility representative and a copy was provided as well as appeal rights.