Facility Evaluation Report

Licensing Program Analyst (LPA) Cheryl Goodrich arrived at 8:54 AM. to conduct an announced Pre-Licensing visit. LPA met the Administrator, Cheryl Balquiedra at the front door and was granted entry. The purpose of today’s visit is to inspect the facility to ensure that the facility meets the licensing requirements according to California Code of Regulations, Title 22, Division 6. The facility is approved for 4 residents ages 18 to 59

Infection Control: The facility has an approved infection control plan and a surplus of supplies for infection control including but not limited to mask, gloves, gowns, first aid kit, and cleaning supplies.

Physical Plant and Environmental Safety : The facility temperature read at 70 degrees. The facility consists of 4 resident bedrooms and 2 resident bedrooms with a single bed in each room, 1 care staff bedroom with a bathroom, living room, kitchen, and backyard. The bedrooms are furnished with lighting, closet space, and dresser. The beds are clean and have clean linens and the pathways are clean and clear of obstruction. The bathroom temperature read at 114 degrees within regulation requirements. The living room and kitchen are clean and clear of obstruction. The medications are stored in a locked container in the kitchen and inaccessible to the resident. The facility and has a current fire clearance, smoke and carbon monoxide detectors and fire extinguishers and are in working order.