Facility Evaluation Report

Licensing Program Analyst (LPA) Mary Rico made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA met with caregiver Tairmauli Limbong and was granted entry to the facility. The Administrator Ron Bautista was contacted and informed the reason of today's visit.

The facility is an Adult Residential Facility (ARF) licensed for a capacity of four (4). The facility is defined as level 6 home vendorized by Inland Regional Center (IRC). The current census is four (4) clients. LPA was accompanied by staff Tairmauli Limbong to conduct a general overall inspection, which included, but was not limited to, the following:

The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to interior and exterior passageways. The facility is maintained at a comfortable temperature. LPA inspected client bedrooms; they are equipped with required furniture such as: mattresses, nightstands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA observed sufficient furniture and lighting throughout the facility. The facility is equipped with operating smoke detectors and carbon monoxide alarms. The postings such as the facility license, personal rights, the CCL complaint poster, and the disaster plan were posted in a common area. The cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to clients in care. There was a designated office for client files and staff files. The non-perishable and perishable food supply is sufficient for the clients in care. The facility has sufficient care staff for coverage 24 hours a day, 7 days a week.