Facility Evaluation Report

Licensing Program Analyst (LPA) Carmen Lopez conducted an announced Pre-Licensing and Component III inspection at an Adult Residential Facility for a change of location on today's date to inspect the facility for compliance with Title 22, Division 6, Chapter 8 of the California Code of Regulations and the Health & Safety Code. After arriving at the facility, LPA identified herself, disclosed the purpose of the visit and was granted entry by Elizabeth Rivera, Facility Manager.

LPA toured the physical plant, inside and out, and observed the following: Resident accommodations will be brought in with the clients from the former facility along with the furnishings, linens, and personal hygiene items; resident bathrooms will be equipped with non-skid flooring; water temperatures were measured at: downstairs bathroom- 118 degrees Fahrenheit (F); Kitchen faucet – 116.2 degrees F; upstairs shared bathroom 115.2 degrees F; master bedroom sink – 114.1 degrees F; the facility’s ambient room temperature was 75 degrees F at the time of the visit; medications will be stored in a locked cabinet located in the dining area. Sharps objects will be in the same locked cabinet in a different drawer. Staff and resident records will be kept in a secured cabinet in the office area located in the main living room; Food service including dishes, utensils, food storage, and a seven (7) day supply of non-perishables; the two (2) day supply of perishables will be brought over from the former facility once required approval is met. Toxic substances will be stored in a locked cabinet in the garage; first aid kit with required supplies and first aid manual were purchased and will be stored in one of the drawers inside the locked medication cabinet. Activity supplies will be brought over from former facility and placed in the family room area. There is sufficient space in which to conduct activities; fire extinguishers were present; smoke and carbon monoxide detectors were present and operable; required facility postings were present and visible in the common area of the facility.