Facility Evaluation Report

Licensing Program Analyst (LPA) Amy Rodgers 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 herself to, and discussed the purpose of the visit with House manager Amanda Allock . Administrator Martha Sell later joined the visit.

According to the facility’s license, the facility has a maximum capacity of four (4) residents, all of which are ambulatory. During today’s inspection, there were a total of four (4) clients in care. This facility does not feature a secured perimeter or delayed egress doors.

LPA, accompanied by licensee’s staff, toured the interior and exterior of the facility, and inspected each common area and resident rooms. The resident rooms clean and in adequate repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. doors, windows were in working order. Extra linens and hygiene supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. The facility’s ambient internal temperature was compliant. Refrigerator temperature and freezer temperature were compliant.

There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present. There were no sharp objects, toxic chemicals/poisons, fireplaces, or open-faced heaters accessible to clients. Medications were labeled, as required, and stored in locked areas. Medical confidential records were stored in locked areas.