Facility Evaluation Report

Licensing Program Analyst, Amber Coleman, (LPA) arrived at the SRI Enterprises Graceful House unannounced to conduct an Annual Inspection. LPA met with Administrator, Sriadi Sutjiningsih and Staff Member, Joe Kasmijan introduced self and stated purpose of the visit. LPA was granted entry and provided space to work. LPA was informed three residents in care were currently at their programs for the day.

LPA conducted a tour of the facility, inside and outside, and observed the following:

Facility: The facility includes 3 resident bedrooms, 1 staff room, kitchen, living room, den, 2 bathrooms, backyard and attached garage. The facility is vendorized by the Inland Regional Center at level 2. The facility is licensed for four, (4) ambulatory adults. The facility is operating at the capacity and in the conditions approved by Community Care Licensing (CCL).

Physical Plant: LPA Coleman observed the facility's temperatures to be comfortable. The lighting and lamps make for appropriate lighting to ensure residents to ambulate comfortably and safety. The facility is equipped with smoke alarms, carbon monoxide detectors throughout the premises. These were tested and found operational. The fire extinguishers were observed to be fully charged, and last inspected May 2023. LPA Coleman reviewed the facility's Emergency Disaster Plan and Fire Drills and observed that the facility last conducted a Fire Drill on September 2023. LPA observed no pool or bodies of water on facility grounds.

Interior and exterior pathways were free of clutter and unobstructed.

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 and accessible to residents in care. Sharp objects and chemicals are kept secure under the kitchen sink cabinet.

Care & Supervision : Facility has sufficient care staff; who assist residents 24 hours and 7 days a week. According to staff records, all staff files contained verification of all required annual training.

Record Review and Resident/Staff Files: LPA Coleman reviewed records for three, (3) residents currently living at the facility. Resident records are complete with Physician's Reports, Needs and Services Plans and Individual Program Plans. LPA reviewed two, (2) staff files and confirmed that staff records included current