Facility Evaluation Report

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct an annual inspection. LPA met with Eleanor Canosa, caregiver, who contacted Administrator, Nimfa Segovia, by phone. The Administrator arrived shortly. Staff, Daniel Segovia, and Assistant Administrator, Chelsea Naruse, arrived shortly also. The facility is a level 3 home, vendorized by Alta California Regional Center, and is licensed for bathroom to have the necessary grab bars, non-skid flooring, paper towels, trash can with lids and 20-second hand-washing poster. There is sufficient 2+day perishable and 7+day non-perishable supply of (4) ambulatory and (2) non-ambulatory clients. LPA observed (3) clients in the home at the start of the inspection and (1) client return from day program towards the end of the inspection.

LPA and staff, Daniel, toured the interior/exterior of the facility including the common areas, (2) private resident bedrooms, (1) shared resident room, (2) resident bathrooms, kitchen, laundry area/ garage. The upstairs is used for staff only. LPA observed the facility to be clean, in good repair and odor-free and each food. Medications and sharps are locked in the kitchen and toxins are locked toxins near the kitchen. There are sufficient towels, linens, blankets, PPE and emergency supplies. The inside temperature measured 72*F and hot water measured 118*F in the kitchen. The fire extinguisher was last serviced on 1/8/24, and the smoke/monoxide alarms are in working order. LPA observed locks on each client door that were recently installed, as required by Title 17. Clients will be given a key and staff will keep a spare key. There is (1) unlocked exit gate on the outside patio , covered patio seating, and vegetable gardens. House Rules, the license, Covid posters and Personal Rights are posted. Fire drills conducted monthly. First aid kit current.

LPA reviewed (2) of (4) client files and found them to contain current individual/nursing care plans, physician's reports and other documentation. P&I funds reviewed for (1) client and found to be accurate with documentation maintained. Current copy of a surety bond obtained. Medications orders were compared to medications being administered for (1) client -no discrepancies noted. Documentation is current on the Centrally Stored Medication Record and Medication Administration Records. ARF Administrator Cert #7035218735- exp 2/23/25. LPA requested an updated copy of the LIC308, LIC500 be sent to CCLD by 5/15/24. There are no deficiencies issued during today's inspection. Exit interview. Copy of report provided.