Senior Care Records.

Facility Evaluation Report

Gus Residential Home INC., Beaumont03/30/2023Licence 335530081

Capacity4
Census0
Date signed03/30/2023 09:38:21 AM
The inspector’s account

Licensing Program Analyst (LPA) Victoria Chitgian conducted an announced visit to complete a pre-licensing inspection and component III. LPA met with Augusta Momodu. The application is for an Adult Residential Facility. The approved fire clearance granted four (4) ambulatory clients.

The interior and exterior was toured of the pending facility. Overall, the pending facility is clean and in good condition. Floor plan is observed to be consistent with physical plant. LPA observed all bedrooms to be appropriately furnished with adequate lighting. Bathroom toilets are functional. Showers have non-skid mats. The hot water temperature in the kitchen was measured at 117 degrees Fahrenheit. Bathroom hot water temperatures were all measured within required regulatory limits. In the kitchen, LPA observed food storage and preparation areas to be clean and sanitary. Refrigerator and freezer temperatures are maintained at appropriate temperatures. All appliances are clean and operating properly. There is a sufficient supply of linens, towels, and personal hygiene items. The first aid kit was reviewed; all items are present including an approved First Aid Manual.

LPA observed an adequate supply of recreation and leisure items and activities. The backyard is completely enclosed with functioning gate to exit to front yard. Outdoor space is suitable for client use that includes a covered patio with a table and chairs. LPA observed the fire extinguishers to be recently serviced and completely charged. Smoke alarms and carbon monoxide detectors are present and functional. Medications will be centrally stored and secured in a locked cabinet. All hazardous materials such as, cleaning, and disinfecting supplies, knives and other sharps are locked and inaccessible to clients. All required forms are posted in a common area.

Pre-Licensing Inspection and Comp III has been completed and the facility has no deficiencies or corrections.

An exit interview was conducted where this report was discussed and provided to Augusta Momodu.

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