Facility Evaluation Report

Licensing Program Analyst (LPA) Cheryl Goodrich conducted an unannounced annual visit. LPA met with the caregiver Elizabeth OLeary at the front door and was granted entry. Licensee Annie Allen arrived during the visit. The purpose of today’s visit is to inspect the facility to ensure that the facility is following California Code of Regulations, Title 22, Division 6. Facility is approved for six (6) non-ambulatory residents. Three (3) residents are on hospice.

Physical Plant: front entrance, interior and surrounding exterior were clean and in good repair with no pathway obstruction; doorway alarms were in working order; facility temperature read at 73 degrees; residents' main restroom water temperature read at 102.8 degrees; there were no bodies of water on premises; there was sufficient lighting and mattress pads in all of the residents' bedrooms; fire alarm and smoke carbon monoxide detectors were in working order. Facility does not house firearms and/or ammunition on grounds. Cleaning supplies was stored outside in a locked shed.

Food Services: 7-day non-perishable and 2 day of perishable food supply was observed, and all food was properly stored and available to residents.