Facility Evaluation Report, 10/03/2024

Licensing Program Analyst (LPA) Christina Valerio arrived unannounced to conduct an annual required inspection and follow up on an UIR submitted to the Regional Office. LPA Valerio met with Designated staff/House Manager (HM), Brittney Chaves, and explained the purpose of the visit.

LPA Valerio and HM Chaves discussed follow up regarding the UIR involving Resident 1 (R1). HM stated that an in-service was provided with staff regarding showering protocols. LPA Valerio and HM Chaves toured the facility to ensure compliance with Title 22 regulations. LPA Valerio observed the common areas to be clean, organized, and free from odors. Residents were observed walking around the facility, watching a movie, and arriving from Day Program. Staff were observed assisting residents, completing paperwork, and assisting with ADLs. Resident bedrooms were observed to be clean and fully furnished. Linens were observed to be clean. Resident bathrooms were equipped with a shower chair, grab bars, hand soap, paper towels, toilet paper, and hygiene products. Sharps, chemicals, and hazardous materials were locked and inaccessible to residents in care. Carbon Monoxide detectors, fire extinguisher, and air conditioning were in working condition. The facility was observed to have an adequate food supply to meet requirements. The backyard area was observed to have enough space for outdoor activities and outdoor visitation. The room located in the backyard is currently being utilized for a recreational/storage area. Residents do not have access to this area; however, it can be utilized for a quarantine room for future use.

LPA Valerio reviewed staff and resident files. It was observed to be complete with required documents.

LPA requested the following annual documentation be sent by 10/16/2024: LIC 500, LIC 308, LIC 610D, Copy of Surety Bond, and a copy of Bacteriological Analysis of Private Water Supply (if applicable).

Per California Code of Regulations (CCR) - Title 22 - no deficiencies are being cited today. An exit interview was held, and a copy of the report was provided.