Facility Evaluation Report

On this day Licensing Program Analyst (LPA) Fred Arias made an unannounced visit to conduct a required annual visit. LPA called licensee Kevin Clark over the phone to discuss the purpose of the inspection as no one was present at the facility. Kevin stated he would send Administrator (AD) Laura Palomino to help facilitate inspection. AD arrived shortly to conduct facility tour. Facility is licensed for four ambulatory clients with no clients living at the facility at this time.

LPA along with AD toured the facility at 2:20 PM. LPA toured the physical plant, checked food service, and facility documentation. The home consists of four client bedrooms, living room, dining room, and kitchen, three bathrooms and an attached garage. Client bedrooms had the required furniture and closet/drawer space to accommodate each client comfortably. Client bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure and shower was free of mold/mildew. Water temperature measured between 115.1 degrees F and 117.8 degrees F in all bathrooms. Common areas were clean and clear of hazards. Kitchen appliances were operational during today's visit. Smoke detectors tested operational during today's visit. Fire extinguishers were fully charged. LPA reviewed the emergency disaster plan and plan is complete and thorough. Outside grounds were toured. Walkways around the home were clear of hazards. There is shaded outdoor seating for clients. Exit gates are unlocked and operational. LPA observed the emergency food and water supply. First aid kit contained all required items including tweezers, scissors and thermometer. No files were reviewed as there are no clients in care or staff assigned to the facility. Based on the observations made during today’s visit, no 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.