Facility Evaluation Report

On June 23, 2023, Licensing Program Analyst (LPA), Venus Mixson arrived unannounced at the facility in order to conduct the required annual inspection. LPA Mixson met with the Lead Caregiver, introduced herself, and stated the purpose of the visit. LPA Mixson toured the facility inside and outside. The facility is a single story home located at 1082 Eden Valley Way, San Jacinto, CA. 92582. There are currently two staff and four residents present.

Physical Plant: The facility, is in good condition, neat, and orderly. Outdoor and indoor passageways were free of obstruction at the time of this visit. The restrooms were equipped with liquid soap and paper towels. LPA Mixson toured the kitchen and observed the staff and residents having diner. The facility had an activity schedule posted for review. The facility has emergency food and water. Smoke detectors are operable and show green light. The fire extinguisher was in the green. Carbon monoxide alarms, along with smoke detectors were observed. There was a locked and centralized storage area for medications. Medications are contained in bubble packs and bottles. The facility had a designated area for resident and staff files. Emergency disaster plans, personal rights, and complaint procedures were posted in a prominent area. There was adequate seating in the common areas and sufficient space for activities. LPA Mixson reviewed two staff files four resident files, and conducted two staff interviews and two resident interviews. There were no regulation violations observed during todays visit.

An exit interview was conducted and a copy of this report, along with the LIC811, was provided to Lead Caregiver.