Facility Evaluation Report

Licensing Program Analysts (LPAs) Nacole Patterson and Eryn Kane conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPAs were welcomed by and discussed the purpose of the visit to HR Administrator Janette Martinez. The facility's license shows a maximum capacity of 42 ambulatory residents, 10 of whom can be non-ambulatory. During today’s inspection there were 28 residents in care.

LPAs and HR Administrator Janette Martinez toured the interior and exterior of the facility and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Rooms contained the required furnishings. Doors, windows, screens, and toilets were in working order. Hygiene supplies were present, as well as Personal Protective Equipment. The facility had sufficient space and equipment to facilitate dining, visitation, meetings, and client activities. The facility contained at least 2 days of perishable food, and at least 7 days non-perishable food, all safely stored. Cooking, dining equipment, and utensils were present. No toxic chemicals or poisons were accessible to clients. Medications were labeled, as required, and stored in locked areas. No pools or bodies of water exist on the premises. Per HR Administrator Jeanette Martinez, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all in working order. Fire extinguisher(s) were serviced within the last 12 months. First aid kit(s) were complete and readily accessible. Required licensing postings were observed in visible areas of the facility.

LPAs interviewed staff and reviewed facility records. The files reviewed by LPA contained required documents with the exception of two staff files, which did not have required health screenings. Confidential records were stored in locked areas.

Deficiencies are cited per California Code of Regulations, Title 22 (refer to the attached LIC 9099-D). A Plan of Correction was jointly developed with the licensee. An exit interview was conducted with HR Administrator Janette Martinez, to whom a copy of this report, the LIC811 Confidential Names List, and the Licensee/Appeal Rights (LIC9058 03/22) were provided.