Facility Evaluation Report

Licensing Program Analyst (LPA) Magda Malcore conducted an unannounced visit to the facility to conduct a required comprehensive annual inspection. LPA met with Nikki Von Jena, Facility Representative and discussed the purpose of the visit.

The facility is an Adult Residential Facility (ARF) with a license capacity of (4) and current census of (0) clients. The facility is pending vendor certification through Inland Regional Center (IRC). LPA conducted an overall inspection of the facility, which included, but was not limited to, the following:

Physical Plant: The facility is operating in the capacity approved by the Community Care Licensing Division (CCLD). Indoor and outdoor passageways were kept free of obstruction. The facility has no swimming pools or similar bodies of water. The facility has sufficient indoor and outdoor space for client activities. The facility is maintained at a comfortable temperature. Four (4) client bedrooms inspected were furnished with clean bed linen, mattresses, night stands, chairs, storage space, and sufficient lighting. Two (2) client bathrooms were observed clean and fixtures were operating properly. The hot water temperatures in the bathrooms measured 105- and 114- degrees F. The facility maintains a sufficient supply of bed linen, towels, personal protective equipment products, and personal hygiene products. The facility has a locked room were client files and medications will be centrally stored. The facility is equipped with operating laundry equipment, telephone service, and a centralized fire/carbon monoxide system. Posters such as client personal rights, the Community Care Licensing complaint poster, disaster plan, facility sketch with exit points were posted in a common area. Cleaning supplies, toxins, and sharps were kept locked.

Food Service: Kitchen and dining areas were maintained clean. The facility has a sufficient space for non-perishable and perishable foods. The facility refrigerator and freezer were maintained in healthful manner.