Facility Evaluation Report
On 11/14/2024 at 10:30 AM, Licensing Program Analyst (LPA) Melody Brown made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA Brown met with a staff and was granted entry to the facility. At the time of the visit there were two (2) staff present, and five (5) residents present. Licensee/Administrator Maria Aguilar was contacted and informed of the visit. Licensee/Administrator Aguilar arrived during the visit. LPA Brown explained the purpose of the visit to Licensee/Administrator Aguilar.
The facility is a six (6) bedroom, two (4) bathroom home with a kitchen/dining area, living room, and an attached garage. The facility is licensed for a capacity of six (6) non-ambulatory residents, one resident (1) can be bedridden. The current census is five (5) residents. LPA Brown was accompanied by Licensee/Administrator Aguilar to conduct a general overall inspection, which included, but was not limited to, the following:
Physical Plant : The facility is operating in the capacity approved by Community Care Licensing Division (CCLD). There are no obstructions to interior passageway, however LPA Brown observed obstructions to exterior passageways as evidenced of broken bed, household appliances, and other woods and metals observed. Deficiency will be issued. The facility is maintained at a comfortable temperature of 73 degrees Fahrenheit. LPA Brown inspected resident bedrooms; they are equipped with required furniture such as: mattresses, night stands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA Brown observed sufficient furniture and lighting throughout the facility. LPA Brown measured and observed the water temperature in the residents/staffs shared bathroom to be at 106 degrees F. The facility is equipped with operating smoke detectors and carbon monoxide alarms. Postings such as the facility license, personal rights, the CCLD complaint poster, ombudsman poster, and the disaster plan were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were not kept inaccessible to residents in care as evidenced of two (2) sharp scissors in the kitchen drawer, not locked and accessible to residents in care. ***Continuation in LIC809C*** ***Amended Copy of LIC809**
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction