Senior Care Records.

Facility Evaluation Report

We Share, We Care, Apple Valley01/19/2023Licence 365530066

Capacity4
Census0
Date signed01/19/2023 11:50:36 AM
The inspector’s account

Licensing Program Analyst (LPA) Victoria Chitgian conducted an announced pre-licensing visit to the facility. LPA met with Licensee Wilson Bryant III. The pending application is for a Residential Care Facility for the Elderly (RCFE). Currently there are zero (0) residents in care. Licensee accompanied LPA on a tour of the interior and exterior of the facility. The home is a two (2) story, two (2) bedroom, three (3) bathroom with a living room, dining room, and kitchen. Upstairs area will be used as office space, storage and resident room. The physical plant, in general, was in good repair. Buildings and grounds are free from hazards. Indoor and outdoor passageways are free of obstruction. There are no pools, bodies of water, firearms or ammunition. All bedrooms are furnished with a bed, nightstand, dresser and chair. All bedrooms have adequate lighting for resident use. Bathroom’s toilet, shower and tubs are in good repair and have non-skid mats and grab bars. LPA measured and observed the water temperature in the bathrooms to be at 116 degrees F. LPA observed food storage and preparation areas to be clean and sanitary. Refrigerator and freezer are maintained at appropriate temperature. All appliances are clean and operating properly. Dishes, glasses, and utensils were in good condition. There is sufficient supply of linens, towels, and personal hygiene items. The first aid kit was reviewed; all items are present. The exterior is enclosed with functioning gate to exit to the front yard. Outdoor space is suitable for resident use with a covered patio and bench. LPA observed full charged fire extinguisher present at the facility. Smoke alarms, carbon monoxide are present and functional. Medications are to be stored and secured in a locked cabinet inside closet. The facility has a designated area for staff and residents’ records. Emergency disaster plans, personal rights, and complaint procedures were posted in a prominent area. There is adequate seating in the common areas. Facility has a supply of activities for residents.

Pre-licensing inspection is complete, and no corrections are needed to be made.

An exit interview was conducted, and a copy of this report was provided to the licensee Wilson Bryant III.

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