Facility Evaluation Report

Licensing Program Analyst (LPA) Cheryl Goodrich arrived at 12:39pm to conduct an unannounced annual visit. LPA met the House Manager, Cedrick Williams at the front door and was granted entry. The purpose of today’s visit is to inspect the facility to ensure that the facility is following California Code of Regulations, Title 22, Division 6. Facility is approved for 5 ambulatory residents with 4 residents in care. The facility is a single-story home.

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 76 degrees. The facility consists of 4 resident bedrooms, and 3 bathrooms, 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 127 degrees which is outside regulation requirement, however the facility has posted caution notice sign. The living room and kitchen clean and clear of obstruction. The medications are stored in a locked cabinet in the kitchen and inaccessible to the resident. The facility has a current fire clearance, smoke and carbon monoxide detectors and fire extinguishers and are in working order.

Personnel Records-Training: The staff records are completed with fingerprint clearance, Health screening for TB, CPR/First Aid training, and in-service trainings.

Client Records-Incident Reports: The facility has identification and emergency information, physician’s report, resident appraisal, IPP, client rights, and admissions agreements.