Facility Evaluation Report

On March 12, 2024, Licensing Program Analyst (LPA), Venus Mixson arrived at the facility unannounced, and conducted the Required Annual Inspection . The LPA met with the Administrator, Katherine Dowden. The Facility file review was conducted in the Regional Office and additional forms were reviewed and requested on site. The facility is operating at the capacity of three residents, but licensed for four.

LPA Mixson toured the facility along with the Administrator, Katherine and inspected the facility inside and outside. There were no obstructions to the indoor or outdoor passageways currently at the time of this visit. The pool was locked currently at the time of this visit. The facility is a single-story home located at 3916 Limber Pine Road, Fallbrook. CA 92028.

Physical Plant: The facility phone number is (760) 731-2220 and is operable. The LPA observed the residents’ bedrooms, and each was equipped with required furniture as per Title 22. LPA Mixson inspected facility bathrooms, and the hot water temperature tested within regulations. The bathrooms were clean, and appliances were operating appropriately currently at the time of this visit. The facility is equipped with operating smoke detectors, carbon monoxide alarms, and fire extinguishers. The LPA observed required postings such as "If you See Something, Say Something" the "Personal Rights" and the Ombudsman postings. The cleaning supplies and sharp items were kept locked and inaccessible to the residents in care. There was a designated storage space for the residents and staff files, and it was locked and inaccessible to residents in care currently at the time of this visit.

Medications : were locked and inaccessible to residents, and there was a sufficient supply of medication for residents in care. The overall facility is clean, the furniture is in good condition. The facility heating system and other appliances were operable currently at the time of this visit.

Food Service: Non-perishable and perishable food supply is sufficient per regulations, and there are a variety of food types available for residents. Dishes and utensils were in sufficient supply and stored properly.

Care & Supervision : Facility has sufficient staff, two staff on site at the time of this visit, while the residents in the community at the Day Program.

Records Review: The LPA reviewed resident and staff files, and conducted staff interviews, and no residents were interviewed due to the residents being in the community. Previous Community Care Licensing forms were reviewed. There were no Title 22, Division 6 Regulation violations observed or cited during today’s visit.

An exit interview was conducted, and a copy of this report was given to the Administrator, Katherine Dowden.