Facility Evaluation Report

Licensing Program Analyst (LPA) Ruth Wallace conducted unannounced Required 1 Year Annual Inspection Visit. LPA met with met with caregiver and explained purpose of visit.

During today's inspection, 3 clients were home and 2 staff were on duty. This facility operates as a level 4I home vendorized by Alta California Regional Center. The interior and the exterior of the facility were inspected including the common living spaces, resident bedrooms and bathrooms, and kitchen. Bathrooms and bedrooms were clean and in good repair. There is a locked storage for medications and toxins. Food supply is adequate for 2 day perishable and 7 day nonperishable. Fire extinguishers were inspected 2/28/22. Smoke alarms were checked and in found in good working order. Fire drills are conducted as required. Carbon Monoxide detector was found in good working order. The hot water temperature was measured 108.4*F which is within the required range of 105-120*F. LPA observed a sufficient amount of towels and linens. This facility is operating within the scope of their license.

LPA reviewed two (2) resident and three (3) staff records. Resident files were found to be complete and current. A review of staff records indicates that all facility staff have received criminal record clearances and/or are associated to this facility. Staff records reviewed indicated current first aid certificates. Facility is conducted staff training as required.

Per the California Code of Regulations, Title 22, Division 6, Chapter 8, no violations were observed during this visit. Exit interview held with house manager and a copy of report given.