Facility Evaluation Report

Licensing Program Analyst (LPA) Seo Jeon made an announced visit to the facility for the purpose of conducting a prelicensing inspection. LPA met with Applicant, Camilla Campbell, who accompanied LPA for the inspection. The Applicant has submitted an application for 4 residents (4 non ambulatory). On 7-22-2024, the Riverside County Fire Department approved a fire clearance for which the applicant has applied for.

The home is a single story structure consisting of 4 bedrooms, 3 bathrooms, kitchen, dining room, family room and attached garage. There is no swimming pool or body of water in the facility. The bedrooms were observed to have bed, lighting, night stand, chest of drawers and area for sitting. The bathrooms had nonskid mats and grab bars. There is plenty of extra linen (sheets, blankets, towels) that were observed to be in good repair. The smoke and carbon monoxide detectors are a dual system that were tested and found to be operable.

The hot water temperature was tested and was found to be within regulatory limits measuring at 110 degrees Fahrenheit. The facility is equipped with flashlights and night lights. The facility has an emergency disaster plan and infection control training plan on file. The facility has a sufficient supply of dishes, cooking and eating utensils, that were observed to be in good repair. The facility food supply was observed to be sufficient as there was 2-day supply of perishable and a 7-day supply of nonperishable food items. The facility has an emergency food and water supply. There is a fully stocked first aid kit.

The passageways, and ramps/inclines are clear and free from obstruction. The home has 1 fully charged fire extinguisher with current tag. The facility does not have any known guns or ammunition stored on grounds. The sharps/knives are stored in a locked cabinet in the kitchen. The medications will be kept in individual boxes that will be stored in a locked cabinet located in staff room.