Senior Care Records.

Facility Evaluation Report

Specialized Residential Lupine, Apple Valley09/16/2024Licence 366425780

Capacity4
Census4
Date signed09/16/2024 11:47:59 AM
Name of licensing program analystMagda Malcore
Name of licensing program managerKaren Clemons
The inspector’s account

Licensing Program Analyst (LPA) Magda Malcore made an unannounced visit to the facility to conduct a required annual inspection. LPA met with House Lead, Rasheena Ross, and discussed the purpose of the visit.

The facility is an Adult Residential facility with a license capacity of (4) and a current census (4). LPA conducted an overall inspection, which included, but was not limited to, the following:

Operation/Physical Plant: Indoor and outdoor passageways were kept free of obstruction. The facility has no swimming pools or similar bodies of water. The facility has sufficient indoor and outdoor activity space for clients in care. The facility is equipped with smoke/carbon monoxide alarms, laundry equipment, bed linen, towels and telephone service. Client bedrooms were equipped with beds, bed linen, nightstands, chairs, storage space and bedroom lighting. Client bathroom equipment was operating in safe conditions. The hot water in client bathrooms tested at 109 degrees F. Sharps and cleaning supplies were store in a locked cabinet. The facility has posted: facility license, evacuation plan, client personal rights and planned activities. The Administrator's certification and facility's insurance is current.

Care and Supervision: The facility has 24 hours, 7 days a week care staff.

Food Service: The facility’s kitchen area was maintained clean. The facility has sufficient non-perishable and perishable food for number of clients in care.

Health Related Services: The facility maintains records of client medications and medications are centrally stored in a locked cabinet.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction