Facility Evaluation Report
Licensing Program Analysts (LPAs) Amy Domingo conducted an unannounced visit to conduct a Required Annual Inspection. LPA were welcomed by, identified themselves to, and discussed the purpose of the visit with Administrator Jane Antonio.
During today’s inspection, there were three (3) clients, licensed for four (4). During today’s visit, LPA accompanied by the Administrator, toured the interior and exterior of the facility, and inspected all common areas and resident bedrooms and bathrooms. Inside the facility was clean, sanitary, and in good repair. Inside pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, windows and screens, toilets, and showers were working. The facility had sufficient space and equipment to facilitate dining, visitation, meetings, and client activities. The facility’s ambient internal temperature was complaint. Hot water temperature at taps accessible to clients were complaint. At the time of the visit there were at least (2) days of perishable food and at least seven (7) days non-perishable food present, all safely stored. Smoke detectors, carbon monoxide detectors, emergency lighting, night lights, and facility telephone were all working. The facility’s fire extinguisher was serviced within the last twelve (12) months. No pools or bodies of water were observed on the premises. Per the licensee's staff, no firearms or ammunition are kept at the facility. Required licensing postings were observed in visible areas of the facility. The reviewed files contained required documents. Confidential records were stored in locked areas. LPA observed that residents were being treated with dignity by staff, and there were sufficient staff on duty to meet resident’s needs. No deficiencies were observed or cited during today's annual inspection.
An exit interview was conducted with Administrator Jane Antonio. A copy of this report, and the Licensee/Appeal Rights (LIC9058 03/22) were provided to Licensee during today's visit
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction