Facility Evaluation Report

Unannounced Annual Inspection visit was made by Licensing Program Analyst (LPA) Kimberly Viarella to this facility on 01/13/25. LPA identified herself upon arrival, stated the purpose of the visit, and asked to speak with the Designated Facility Administrator (DFA). LPA met with Designee, Raquel Harris, who also had her administrator's certificate. A brief interview followed. LPA requested the following documents:

LIC 308: Designation of Administrative Responsibility

LIC 309: (for any LLC or Corp) if applicable

LPA noted Designee's certificate # 6023431735 and it expired 12/16/24. The Licensee/Administrator, completed the necessary steps to renew their certification in September of 2024 and LPA requested proof of submission be emailed to Community Care Licensing at CCLASCPSacramento@dss.ca.gov.

LPA noted Designee's certificate # 7027573735 and it expires on 04/11/2026.

LPA compared the LIC 500 with the roster of staff obtained from Guardian to ensure that all staff had the appropriate background clearances to be working with the residents in care. All were in compliance at the time of this inspection.

LPA inspected the 3 resident bedrooms. All had the required furniture, furnishings and lighting to be in compliance at the present time. All other common areas were also in compliance.