Facility Evaluation Report

On 02/12/25 Licensing Program Analyst (LPA) Javina George made an unannounced visit to the facility to conduct a 1 year required visit. LPA was greeted by Caregiver, Armida Benaires and explained the purpose of the visit. At the time of visit, there were (2) clients home and (2) staff were available. The facility is licensed to serve six (6) developmentally disabled adults, ages 18 to 59, all of whom may be non-ambulatory. The Administrator Bency Jimenez stated that he would try to make it to the facility within the hour as he had the Personal and Incidental funds with him. Administrator did not arrive by the time LPA concluded the visit therefore the funds were not reviewed during today's visit.

The facility is a two story structure consisting of five (5) client bedrooms, (2) bathrooms, backyard, kitchen, garage, and den on the first floor. On the second floor consists of (2) staff bedrooms and (1) bathroom. The client bedrooms and bathrooms were observed to be clean. The hot water temperature was tested and measured to be 116 degrees Farenheit to be within regulatory limits. The facility had an adequate food supply, as there was a 2 day supply of perishable and a 7 day supply of nonperishable food items. The facility activities to promote socialization.

The emergency disaster drills are being conducted on a monthly basis and that last fire drill was conducted on 1/12/25. There are no known guns or ammunition, or bodies of water on the premises. The chemicals and sharps were observed to locked and inaccessible to clients in care. The client files were reviewed and had the required documentation.

LPA conducted a staff file review and observed for Staff #1 (S1) to not have an employee file to review, nor to be associated to the facility. LPA cited immediate civil penalties of $500.00. LPA discussed the importance of having employee files available for review when requested by the department, and the potential consequences for not doing so. Based on today's inspection a citation will be issued in accordance with the California Code of Regulations (Title 22, Division 6, Chapter 6) on the attached 809D.

An exit interview was conducted and a copy of this report, 809D, LIC421BG, and appeal rights were reviewed and provided to Leah Portillo, Caregiver.