Facility Evaluation Report

Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to conduct the required annual inspection. LPA met with Administrator Noel Gutierrez and explained the reason for the visit. LPA observed and the Administrator verified they have no current Administrator's certificate. LPA and the Administrator toured the facility. Facility is a two story house. The second floor is for staff only. No residents live upstairs. LPA observed an emergency evacuation chair at the top of the stairway. LPA observed the kitchen is clean and organized. Knives are kept locked in a kitchen drawer. LPA observed a 2 day supply of perishable and a 7 day supply of non-perishable food on hand in the kitchen. LPA observed the cleaning supplies are kept locked under the kitchen sink. LPA observed the See Something, Say Something poster (PUB 475) is 8 1/2 by 11 inches and posted in the family room. LPA observed the medications are kept locked in the hall closet. LPA observed all the resident rooms had the required furnishings. The smoke detectors/carbon monoxide detectors tested operational. The Administrator reported there is no documentation for the last fire drill conducted earlier this year. LPA observed all 4 bathrooms on the first floor are clean and operational. Hot water measured 115.4 degrees Fahrenheit in bathroom 2. LPA observed the garage is kept locked and used for storage. LPA and the Administrator toured the backyard. No bodies of water observed. There are 4 storage sheds in the backyard. The sheds are kept locked and used to store extra furniture and supplies. There are two shaded seating areas in the backyard. Both exit gates are operational. LPA reviewed 5 resident files and medications. LPA observed 3 out of 5 residents, Resident 1, Resident 2 and Resident 4 did not have a current appraisal. Resident 1 did not have a medical assessment. No other discrepancies observed. LPA reviewed 2 staff files. No discrepancies observed. Both staff members are background cleared and associated to the facility. Both staff members had the required training and current CPR and First Aid training. LPA inspected the first aid kit. The first aid kit has all the required elements. LPA observed and the Administrator verified their is no dedicated internet device for resident use. Deficiencies are being cited per Title 22 Division 6 of the California Code of Regulation. An exit interview was conducted with the Administrator and a copy of the report along with appeal rights was provided.