Facility Evaluation Report

On December 22, 2022, at 8:30pm, Licensing Program Analyst (LPA) DeAnna Williams-Lyons arrived unannounced to conduct a required Annual Inspection. LPA met Joy Molina and informed her the reason for the inspection. Prior to initiating the inspection LPA completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms; and completed a facility risk assessment. LPA ensured she applied hand sanitizer before entering the facility and wore a mask for Personal Protective Equipment (PPE).

Joy and LPA completed the inspection tool questionnaire with no issues or advisories to report.

Administrators Certificate is valid expiring 8/17/2023. First Aid Kit was complete and ready for emergency use. Fire extinguishers fully charged. Smoke detector and Carbon Monoxide detector are functional. Facility has required (2) day perishable supply of food and (7) supply of non-perishable food. Common areas were clean and in good repair. Bedrooms had the required lighting and furniture. Bathrooms were clean.. Medications were properly stored and locked away.

As a result of this visit, no deficiencies were cited, per Title 22 Regulations, Division 6.

The administrator shall submit updated copies of the LIC 500 Personnel Report, LIC 308 Designation of Administrative Responsibility, LIC 610D the Emergency Disaster Plan, and copy of current Liability Insurance to update the facility file in our Regional Office. Administrator shall submit the listed documents to Licensing later than January 22, 2023.

An exit interview was conducted and a copy of this report was given to Joy.