Facility Evaluation Report

Licensing Program Analyst (LPA) T. White arrived to conduct an unannounced Required 1-Year Annual inspection on this date. LPA met with Administrator/Licensee, Himat Singh, and explained the purpose of the inspection. LPA was allowed entry into the facility that is licensed to serve a total capacity of 15 ambulatory clients.

LPA toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. LPA observed lighting in all rooms are adequate for the comfort and safety of the clients. Hot water temperature in the shared clients’ bathroom was measured at 105.1 degree Fahrenheit. All toilets, hand washing, and bathing are safe, sanitary and in operating condition. There is a minimum of 7-day nonperishables and 2-day perishables foods.

LPA observed smoke detectors and carbon monoxide were in operating condition during inspection. Fire extinguisher was last serviced on April 12, 2021. First aid kit was observed to be complete. Fire drill was conducted on 03/16/2022.

- LPA observed Staff #1 (S1) is not fingerprint cleared or associated to the facility. Licensee stated he received a letter from the Department of Justice (DOJ) regarding S1's clearance. However, there is no proof S1 is cleared in CCLD database.

The following forms to be updated and submitted to CCLD by 03/25/2022 :

LIC 308 Designation of Administrative Responsibility

The following deficiency was observed (see LIC 809D) and cited from the California Code of Regulations, Title 22. Failure to correct deficiency may result in civil penalties.

Exit interview conducted with Administrator/Licensee. A copy of report and Appeal Rights given.