Facility Evaluation Report

Licensing Program Analyst (LPA) Claudia Gutierrez made an unannounced visit for the purpose of conducting a Required/Annual Inspection. LPA was greeted and granted entry by Staff Tony Alejan.

During the inspection LPA and Staff Alejan conducted a tour of the inside and outside of the facility, common areas, resident rooms, staff room, kitchen, garage and observed the following:

This is a one-story house with four resident bedrooms, two bathrooms, and one staff bedroom. Resident bedrooms were observed to have the required furnishings. LPA observed resident beds had linens and blankets. LPA observed all windows were screened. The back yard has a shaded sitting area. LPA observed facility resident relaxing in the living room. Bathrooms were observed to be free of debris and mildew, faucets and toilets were operational. Water temperature tested at 120.8 F degrees. LPA observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food as required by regulations. Smoke detectors and carbon monoxide detectors tested operational. Fire extinguisher was observed to be fully charged with service tag dated July 8, 2024. Facility appliances, including gas stove, microwave, washer and dryer tested operational. All and any toxic chemicals, cleaning solutions, laundry toxins and disinfectants are inaccessible to resident. Medication was observed to be centrally stored and locked in a cabinet. A copy of current liability insurance certificate was not available for review and Staff was unable to provide LPA with a copy; a Deficiency was cited on today's date. LPA reviewed one of one resident file and two staff files. LPA interviewed resident and staff present.

Based on the observations made during today’s inspection, one deficiency is being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted, and a copy of this report and appeal rights was left at the facility.