Facility Evaluation Report

This unannounced inspection is being conducted by Licensing Program Analysts (LPAs) Sean Haddad and Kevin Saborit-Guasch for the purpose of conducting a Required – 1 Year Inspection. LPAs met with Staff #1 (S1) Carrie Wicke and discussed the purpose of the inspection. Administrator (AD) Crystal Mccune was not present during the inspection. LPAs reviewed Infection Control requirements. At about 8:45AM, LPAs and S1 conducted a tour of the inside and outside of the facility, common areas, client rooms, kitchen, and garage and observed the following: Structure: facility is a 5-bedroom, 4-bathroom, two-story house with an attached garage that is being used for storage. There is a back yard with a patio cover for the clients. LPAs observed 1 staff and no clients present at the facility. Client Bedrooms: the 3 client bedrooms are spacious and will easily accommodate the clients’ furnishings. Furniture for each client bedroom inspected. Staff Bedrooms: LPAs inspected the 2 staff bedrooms. Bathrooms: the bathrooms were clean, faucets and toilets were operational. Water temperature: tested at 116.9 degrees F in the common client bathroom. Linens & Hygiene Supplies: new linens and fully stocked linen closets were observed. Emergency Phone Numbers, Exit Plan & Menu: reviewed. Food Service: LPAs observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food is available as required by regulations. Carbon Monoxide, Smoke Detectors, Fire Extinguisher: observed and tested. Appliances: stove burners, microwave, washer, and dryer inspected. Knives: observed locked in the kitchen. Toxins: observed locked in the kitchen and laundry room. Medication cabinet: observed to be locked. First-Aid Kit and Activity Supplies: observed and available. Facility’s licensing fees are paid. At about 9:30AM, LPAs reviewed 5 client files and 3 staff files, interviewed 1 staff, inspected medications for 5 clients, and inspected client money and ledgers for 5 clients. During the inspection, LPAs and S1 observed the following: based on observation, the facility's fire extinguisher has not been inspected in over a year; based on observation, the facility has 2 stories but does not have an evacuation chair. Based on the observations made during today’s inspection, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. See LIC809D. An exit interview was conducted and a copy of this report and appeal rights was discussed with and provided to facility representative.