Facility Evaluation Report

Licensing Program Analyst (LPA) Alyssa Ramirez conducted an unannounced Required Annual Inspection to ensure substantial compliance with Title 22 regulations. The facility file was reviewed prior to the visit. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit with Licensee Stacey Russell.

According to the facility’s license, there may be a maximum of four (4) ambulatory clients. During today’s inspection facilities census was four (4) ambulatory clients.

LPA, accompanied by staff, toured the interior and exterior of the facility. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Facility had sufficient food supply. The facility had sufficient space and equipment to facilitate meetings and client activities. Hot water temperature at taps accessible to clients were also compliant.

There were no sharp objects or toxic chemicals/poisons accessible to clients. No pools or bodies of water were observed on the premises. Emergency lighting facility telephone, fire extinguishers and first aid kit were present.

LPA reviewed multiple staff and client records/files. Files reviewed contained required documents. Confidential records were stored in locked areas. Required licensing postings were observed in visible areas of the facility.

No deficiencies were cited during today's annual inspection.

An exit interview was conducted with Licensee to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.