Facility Evaluation Report

Licensing Program Analyst (LPA) Sabrina Calzada and Sacramento North Regional Manager, Alycia Rayner, arrived unannounced to conduct an annual inspection. There was no answer when LPA and RM arrived, so the Administrator/Administrator Designee were contacted by phone. Care staff, Zahra Nabipoor, arrived at 1:05 pm and Chelsea Neruse, Administrator Designee, arrived at 1:20 pm. Administrator, Nimfa, Segovia, arrived at 2:00 pm. There were (3) clients attending day program at the start of the inspection and (1) client returned around 2:30 pm.

LPA, RM and Administrator Designee toured the interior/exterior of the facility including the common areas, (2) private resident bedrooms, (1) shared resident bedroom, (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. Medications and sharps are locked in the kitchen and toxins are locked near the kitchen. There are sufficient towels/linens/blankets/PPE and emergency supplies. Inside temperature measured 71*F and hot water measured 116*F in the kitchen. The fire extinguisher was last serviced on 1/6/25, and the smoke/monoxide alarms are in working order. LPA observed locks on each client door, as required by Title 17. Clients were given/offered 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,Personal Rights and other posters are posted. Fire drills conducted monthly.

LPA reviewed (3) client files and (5) staff files. Files are organized and contain current individual care plans, IPP and physician's reports. P&I funds reviewed for (3) clients- documentation is 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 and Medication Administration Records. ARF Administrator Cert #7035218735- exp 1/13/26. LPA requested an updated copy of LIC500 be sent to CCLD by 5/21/25. There are no citations issued during today's inspection. Exit interview. Copy of report provided.