Facility Evaluation Report

Licensing Program Analyst (LPA) Claudia Gutierrez made an unannounced visit for the purpose of conducting a Required/Annual Inspection. LPA met with Administrator (AD) Paul Shahparaki and discussed the purpose of the inspection.

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

This is a one-story house with three client bedrooms, three bathrooms, and two staff bedrooms. All client bedrooms had the required furnishings. LPA observed all client beds had linens and blankets. LPA observed all windows were screened. The back yard has a shaded sitting area, and backyard pool was observed to be fenced and secured. LPA observed one staff and two clients present. Clients were observed to be leaving for day program and a walk. Bathrooms were observed to be free of debris and mildew, faucets and toilets were operational. Water temperature tested between 113.2 and 118.3 F degrees. LPA observed emergency disaster plan with means of exiting and emergency phone numbers listed and posted by the telephone at the facility. 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. All and any toxic chemicals, cleaning solutions, laundry toxins and disinfectants are inaccessible to clients. Medication was observed to be locked, however, was not observed to be in its original container or packaging; two deficiencies were cited on today’s date. LPA reviewed two client files and AD’s personnel file; a Technical Advisory was given on this date. Clients were not present to be interviewed.

Based on the observations made during today’s inspection, two deficiencies 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.