Facility Evaluation Report
Licensing Program Analyst (LPA Coleman) Amber Coleman and Michelle Echeverria, (LPA) made an unannounced visit to the facility for the purpose of conducting and Annual Inspection. LPAs met with Care Provider, Jeannie Boyle, (JB), who invited LPAs inside facility and provided a space to work. JB contacted Administrator, who arrived later during the visit. JB informed LPAs the current census is 3.
LPA completed a walk through of the facility and review of staff and resident records.
Facility: The Facility is licensed for four (4) ambulatory adults, ages 18 -59. LPA Coleman observed that the facility is operating in the capacity and conditions approved by Community Care Licensing (CCL).
Physical Plant: LPA Coleman observed the facility's temperatures to be comfortable. Showers and toilets are operable. Extra Linens and hygiene items were located in a hallway closest. Each room is equipped with mattresses, nightstands and appropriate lighting to ensure residents comfort and safety. The facility is equipped with smoke/carbon monoxide detectors. The last fire/earthquake drill last conducted 3/2/23.
Food Service: Nonperishable and perishable food is sufficient for number of residents in care. Food is being prepared and stored properly. Facility has a variety of food available for residents.
Care & Supervision : Facility has sufficient care staff; toxic items are inaccessible to residents in care and stored and locked in a filing cabinet in the office.
Record Review and Resident/Staff Files: LPA Coleman reviewed records for all three (3) residents currently living at the facility. One (1) out of three (3) resident records were found to be incomplete. Physician's Report being out of date. LPA Coleman additionally reviewed all two (2) staff files and confirmed that staff records reflect current CPR/First Aid Certification and Criminal Record Clearance.
Administration: Disaster Plan, Ombudsman poster, Administrator Certificate, and facility license are posted through out the facility. Emergency Disaster Plan is current.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction