Facility Evaluation Report

Licensing Program Analyst (LPA) Christina Valerio arrived unannounced to conduct an annual required visit. LPA met with Designated Facility Staff Victoria Gomez, and explained the purpose of the visit.

LPA observed 2 staff on shift and 2 residents waiting for Day Program. LPA toured the physical plant to ensure compliance with Title 22 regulations. LPA inspected resident bedrooms. Resident bedrooms had a bed, night stand, dresser, closet space, and a chair. Resident bathrooms were equipped with hand sanitizer, soap, hand towels, and toilet paper. Hot water was measured within the required range of 105-120.0*F. LPA inspected the kitchen area. The facility was observed to have a minimum requirement of 2 days of perishable food items and 7 days of non perishable food items. An emergency supply of food was observed.The backyard was observed. LPA observed an area for visiting and outdoor activities. Common areas were free from debris and no obstructions of emergency exits. LPA observed the fire extinguisher, air conditioning, carbon dioxide detectors, and fire detectors to be in working condition.

During the visit, staff were assisting with quarterly visits, medications, and preparing for the outing. Residents were observed watching television and waiting for their ride. Residents appeared happy and excited for the day.

LPA reviewed resident and staff files. Resident files were up to date. Staff files were observed to have necessary training.

LPA requested the following documentation be sent to the Regional office: LIC 500, LIC 308, LIC 610D, and Copy of Surety Bond

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