Facility Evaluation Report

Licensing Program Analyst (LPA), Ruth Wallace conducted an unannounced Required 1 Year Annual inspection Visit. LPA met with administrator at the entrance of the facility and explained the purpose of the visit. LPA was sanitized following the facility's entrance health and safety procedures. LPA also had her temperature checked and logged and then signed into the facility.

LPA and administrator toured the facility. The physical plant is consistent with the submitted facility floor plan and has the COVID-19 health and safety signage. There are no obstructions blocking indoor and outdoor passageways. No pools or bodies of water observed. The facility's kitchen is free of debris. Facility refrigerator is stocked with meats, eggs, vegetables, milk, and fruit. There is even-days of non-perishable food supply and two day perishable food supply is sufficient. LPA observed the facility's restrooms as clean and equipped with hand washing signage. The facility's backyard was free of debris.

The clients' bedrooms were inspected and all had the required lighting and furniture. Facility was equipped with smoke detectors and carbon monoxide detectors. LPA also observed the fire extinguisher was inspected 3/10/2023. The facility's first aid kit included the required tweezers, scissors, and a thermometer. Cleaning solutions are stored and locked. Medication supply is also stored and locked. PPE supply is sufficient. Additional wipes and sanitizer are stored in the garage.

Two (2) staff and two (2) resident’s records were reviewed. Staff have current First Aid/CPR certificates. A review of staff records indicates that all facility staff and other individuals who require caregiver background checks have received criminal record clearances.

Per the California Code of Regulations, Title 22, Division 6, Chapter 8, no violations were observed during this visit.

Exit interview held with administrator and a copy of report given.