Senior Care Records.

Facility Evaluation Report

Laguna Stream Family Home, INC., Elk Grove08/28/2023Licence 347001416

Capacity6
Census6
Date signed08/28/2023 12:04:19 PM
The inspector’s account

Licensing Program Analyst (LPA) Christina Valerio arrived unannounced to conduct an annual required inspection. LPA met with facility staff/Program Manager Josephine Shobhna and explained the purpose of the visit.

LPA observed 4 staff on shift and 3 residents in the home. According to staff, the other residents are at their Day program. LPA observed staff cleaning, assisting residents, completing paperwork, and cooking lunch. Residents were observed doing arts and craft, walking around the house, and watching television. LPA toured the facility with Manager Josephine. Resident bedrooms were fully furnished, clean, and organized. Residents bathrooms were observed to be fully stocked with paper towels, soap, toilet paper, and trash cans. Common areas had required furniture with no emergency exits obstructed. Staff bedrooms were observed to be within compliance. LPA observed an emergency supply of food, water, and linens. The facility had a 30 day supply of PPE. Facility has nonperishable foods for a minimum of one week and fresh perishable foods for a minimum of two days. Hot water in the bathroom was measured at 105.8*degrees F. The room temperature thermostat had a reading of 78*degrees F. LPA observed the backyard to have a sitting area for visits/outdoor activities, a garden area, a locked shed for miscellaneous items, a basketball hoop, and refrigerators for staff/residents. LPA observed a pull alarm system and a fire extinguisher, which was fully charge with a last inspection on 05/19/2023. Medications, sharps, and cleaning supplies were locked away and inaccessible to residents in care.

LPA reviewed 6 resident files and 3 staff files. Files were observed to be up to date. LPA spoke to residents and staff during the visit.

Per California Code of Regulations - Title 22, Division 6, no deficiencies were observed during this visit. An exit interview was held with House Manager Josephine, and a copy of the report was provided.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction