Facility Evaluation Report

Licensing Program Analyst (LPA) Javier Prieto made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection LPA met with Licensee Lulu Medina and was granted entry to the facility. At the time of the visit there was one (1) staff present, and one (1) resident were present. The facility is a five (5) bedroom, three (3), bathroom home, with a kitchen/dining area, living room, and detached garage. The facility is an Adult Residential (ARF) level 2 designated home, vendored by Inland Regional Center. Licensed capacity is (6) current census (4). LPA was accompanied by licensee Lulu Medina , to conduct a general overall inspection, which included, but was not limited to, the following:

Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature. LPA inspected client bedrooms; they are equipped with required furniture such as: mattresses, night stands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA observed sufficient furniture and lighting throughout the facility. LPA measured and observed the water temperatures in the kitchen to be at 110.0 degrees F. The facility is equipped with smoke detectors, one of which was observed to be not operational and carbon monoxide alarm, which was found to be not operational. Posters such as personal rights were observed. The disaster plan were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to clients in care.