Senior Care Records.

Facility Evaluation Report

Stevens Adult Residential Care Home, Santa Ana04/01/2022Licence 306004293

Capacity6
Census3
Date signed04/01/2022 04:46:36 PM
The inspector’s account

Licensing Program Analysts (LPAs) Celine De Perio and Joseph Alejandre made an unannounced visit to conduct the required annual inspection (mitigation). LPAs were greeted and granted entry by staff. LPAs explained reason for visit. At 3:50pm, Rommel Mendoza, Administrator arrived at facility. Rommel Mendoza's Administrator certificate expires on 03/06/2024. Staff and LPAs toured the facility. LPAs observed all client bedrooms had the required furnishings. LPAs observed bathroom 1 and determined it was operational and clean. Hot water was measured at 105.6 degrees Fahrenheit. LPAs observed that smoke detectors around the facility were tested and were operational. LPAs observed that fire extinguisher in the dining room is fully charged and was inspected on 02/11/2022, LPAs and staff toured the garage, which is used for storage of supplies and extra food. Garage is inaccessible to clients and is locked. LPAs and staff toured the backyard and no bodies of water was observed. There is a storage shed in the backyard and is used to keep supplies. Facility has a covered patio and a seating area for clients. LPAs observed pathway leading to exit gate is free from hazards and gate is latched and is operational. LPAs and staff toured kitchen, stove lights unassisted, and observed two day perishable and seven day non-perishable food supply on hand, knives are kept locked in a kitchen drawer, cleaning supplies are also kept locked under the sink, and kitchen overall is clean. LPAs observed that fireplace is inaccessible to clients and is no longer being used. Facility medications are stored and locked in a closet. Facility has a mitigation plan that is pending approval. No deficiencies observed during this visit. No deficiencies were cited during this visit. Exit interview was conducted and copy of report was provided to Administrator.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction