Facility Evaluation Report

Licensing Program Analyst (LPA) Cassie Yang arrived unannounced at the facility to conduct a required annual inspection utilizing the full care tool. LPA met with Administrator and explained the purpose of the visit. At the time of LPA's visit, four clients had left to adult day program with two clients remaining at the facility. LPA observed one direct support professional to be working with Administrator.

During today's visit, Administrator was provided a copy of facility pin code for annual licensing fees. Additionally, LPA and Administrator discussed if facility wish to change ownership from sole proprietorship to a limited liability company (LLC), Licensee is to submit a new application to Centralized Application Bureau located at 744 P Street Sacramento, CA 95814 with a new application fee of $908.

LPA and Administrator conducted a tour of the interior of the facility to ensure the health and safety of clients in care. LPA inspected three shared clients rooms, two bathrooms, kitchen, laundry room, office and the common areas. In areas toured, no immediate health and safety concerns were observed.

LPA observed Administrator Certificate to be updated, expiration date of 10/10/2023 - 10/9/2025. LPA observed fire extinguishers recently serviced on 11/15/2024. LPA observed facility having the required posters posted in the common areas. LPA observed sharps, toxins and medications to be locked and inaccessible to clients in care.

File review was conducted for six clients and two personnel. LPA observed facility to have the required documents on file and documents up to date.

As a result of today's inspection, no deficiencies cited.

Exit interview conducted and a copy of the report was provided.