Facility Evaluation Report

Licensing Program Analyst (LPA) Seo Jeon conducted an unannounced visit to the facility for the purpose of a case management. LPA met with Program Manager, Holden Young, and was granted entry. LPA informed the program director the purpose of today's visit.

On 10-29-2024, the Department received summary report and out of compliance letter from Department of Health Care Services.

Facility is a two-story building with 3 client bedrooms, and four 4 bathrooms, a staff office, laundry room, living room, activity room, dining area, and kitchen. LPA observed one of the clients bedrooms with the required bedding and furniture, such as, clean mattresses/linen, night stands, dressers, chairs, lighting, and emergency lighting. Client bathrooms had clean appliances that were operating in safe and sanitary condition. Facility kitchen had the ability to prepare food in clean environment and possessed equipment in good working condition.

Client and staff files were located in cabinets in the locked staff office. Client medication were centrally stored and locked in the staff office. LPA observed required postings including the visitation polices, emergency/disaster plans, complaint procedures, and personal rights.

LPA reviewed 5 resident files and observed all required documents. LPA also reviewed 3 staff files and observed background clearances and CPR/First Aid training certificates.

LPA observed that the physical plant is clean, in good repair, and to be hazard-free during today’s visit. LPA did not observe any health and safety concerns. There were no deficiencies being cited, per California Health & Safety Code and California Code of Regulations, Title 22.

An exit interview was conducted, and this report was discussed and provided to Holden Young, program manager.