Facility Evaluation Report

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual. LPA met with Lita Cailing, Co-Administrator, and explained purpose of inspection. There were (2) clients present at the start of the inspection. LPA observed (3) clients return to the home from their day program. The facility is an Adult Residential Facility (level 3 home) that is vendorized through Alta California Regional Center. Administrator, Maye Dickey, arrived around 2:45 pm and was present until 4:00 pm.

LPA and Co-Administrator toured the interior and exterior of the facility including the common areas, (4) private client bedrooms, (1) shared client bedroom, (2) bathrooms, kitchen, (2) staff rooms, laundry area and outside patio. LPA observed the home to be clean, safe and in good repair and to not pose a health and safety risk or personal rights violation. LPA observed various Covid posters throughout as well as other required postings, including House Rules and personal rights. Administrator certificate #6004281735 (exp 7/10/23) is pending renewal and Administrator certificate #6010165735 (exp 11/25/24). Fire extinguisher last serviced 8/30/22- re-servicing is scheduled for next week. Facility conducts monthly disaster drills. There is a back yard area with covered seating and (2) unlocked exit gates. There are no pools/ponds. LPA observed locked toxins and sharps in the laundry area and locked medications in a separate cabinet. LPA observed sufficient 2+day perishable/7+day non-perishable food and sufficient PPE supplies. LPA observed soap, trash cans with lids and hand-washing posters in the bathroom. LPA observed sufficient towels, linens and blankets and clients are provided with paper towels for hand-washing. LPA observed a completed First-Aid kit and reviewed the Infection Control Plan and found it to be comprehensive. Hot water temperature measured 115*F in the kitchen. Inside temperature measured 72*F. LPA reviewed (3) of (3) staff files- First Aid/CPR and required training is current. LPA reviewed (2) of (5) client files and found them to contain current documentation. Medications were reviewed for these (2) clients- orders match medications being administered and medicationdocumentation is current. LPA requested updated LIC308/LIC610D (9- pg) be provided to CCLD by 8/17/23. There are no deficiencies issued in today's report.

Exit interview. Copy of report provided to Co-Administrator.