Facility Evaluation Report

Licensing Program Analyst (LPA) Amy Rodgers and Licensing Program Manager (LPM) Denise Powell conducted a Case Management visit to address deficiencies. The facility file was reviewed prior to the visit. LPA and LPM were greeted and allowed entry into the facility by caregiver, Julita Renojo, to whom LPA and LPM discussed the purpose of the visit.

According to the facility’s license, the facility has a maximum capacity of ten (10) ambulatory clients. During today’s inspection, there were ten(10) clients in care.

LPA and LPM, accompanied by caregiver Renojo, toured the interior and exterior of the facility, and inspected each room along with bathrooms. The facility was clean and in adequate repair. There were 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, or open-faced heaters accessible to clients. Medications were labeled, as required, and stored in locked areas. LPA and LPM reviewed a sampling of client records and required documents were present.

Deficiency was cited per California Code of Regulations, Title 22 (refer to the attached LIC 809-D page). A Plan of Correction was jointly developed with Caregiver Ronojo. LPA provided technical guidance.

An exit interview was conducted with Caregiver Renojo, to whom copies of this report, the LIC 809-D page, and the Licensee/Appeal Rights (LIC9058 03/22) were provided at the conclusion of the visit.