Facility Evaluation Report

Licensing Program Analyst (LPA) Rose Ruppert made an unannounced visit to the facility today to conduct an Annual Required Evaluation. LPA was greeted and granted entry by Paul Shahparaki, Administrator.

The facility is a level two adult residential single story building with an approved fire clearance for four ambulatory . The facility currently has a census of two clients in care. During today’s visit LPA toured the facility and inspected the physical plant, including but not limited to testing all smoke detectors, testing hot water temperature in three of three client bathrooms, and testing auditory devices on all exits. The hot water temperature measured between 105.1 and 116.2 degrees Fahrenheit and all smoke detectors were operational. The backyard pool is fenced and inaccessible to clients. The fire extinguisher is charged and was serviced on January 4, 2024. The facility needs to conduct a fire drill. LPA inspected the facility food supply and observed the facility retained a minimum of two days perishable and seven days non-perishable food on hand. LPA observed medication storage and reviewed the centrally stored medications. Per review medication appear to be being given as prescribed.

LPA reviewed one of one staff training and fingerprint records. Administrator was taking recertification course for First Aid since it expired on June 14, 2024 during visit. LPA reviewed two of two client records . Client P&I records were reviewed and were accurate. LPA was unable to interview the two clients in care since they were at Day Program. LPA spoke to administrator present regarding care provided. LPA confirmed that administrator has a pending administrator certificate which expired on June 15, 2023 but has provided proof of cashed check and renewal application with education requirements.

Based on the observations made during today’s visit, the facility appears to be in compliance with Title 22 Division 6 of the California Code of Regulations, no deficiencies cited on this date. Two technical violations were given, An exit interview was conducted with Paul Shahparaki, Administrator and a copy of the report, LIC 9102-TV, and files reviewed (LIC 858 and LIC 859) were given at the time of the visit.