Facility Evaluation Report

Licensing Program Analyst (LPA) Andrea Mendivil conducted an unannounced visit for the purpose of conducting a required annual visit. LPA was greeted and granted entry into facility by Caregiver Marisa Notarte and explained the reason for the visit.

At 3:05 PM, LPA toured facility with Caregiver Marisa Notarte. Facility has 2 clients present during today’s visit. Facility is a 4 bedroom, 2 bathroom, single story home with an attached garage. LPA observed a screening and sanitizing station at entrance of the facility. LPA observed clients relaxing in the facility or in their respective rooms. Facility appears clean and sanitary. All clients rooms had required elements, including bed, chair, closet space and ample lighting. Restrooms are stocked with soap and paper towels and have hand washing postings. Facility has 2 refrigerators with ample food supply. LPA observed facility has emergency food and water supply. Facility has a secured location for client files. LPA observed an unlocked medication closet. LPA toured the outside grounds and observed outside visitation area. Exit gate are locked and self latching. Facility has a plan for covid testing clients and staff as needed as well as a plan for isolation. LPA observed a 4 weeks supply of PPE. LPA reviewed all client files and all contained required documentation including updated emergency information. All staff and clients are fully vaccinated for Covid 19.

Based on the observations made during today’s visit, deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. This report was discussed with the facility representative and a copy was provided as well as appeal rights.