Facility Evaluation Report

On November 15, 2023, Licensing Program Analyst (LPA), Venus Mixson made an unannounced visit to the facility to conduct an annual licensing inspection, and met with the Administrator, Leena Dost. The LPA introduced herself and stated the purpose of the visit.

LPA Mixson toured the facility along with the Administrator, and inspected the facility inside and outside, and there were no obstructions to the indoor or outdoor passageways at the time of this visit. The facility is licensed to serve four adult residents, and is currently operating at full capacity.

Physical Plant: The facility is a two story home located at 1260 Avenida Amistad, San Marcos, Ca. 92026, and the facility phone number is (760) 536-3785, and is operable. The LPA observed the resident's bedrooms, and they were equipped with required furniture as per Title 22. The LPA inspected the facility's 2 1/2 bathrooms, and the hot water temperature tested within regulations. The Administrator stated the hot water is tested every two weeks, and it is logged. The bathrooms were clean and appliances were operating appropriately at the time of this visit. The facility is equipped with operating smoke detectors, carbon monoxide alarms, and fire extinguishers, and a first aid kit with manual. The LPA observed required postings such as; the Ombudsman poster, "If you See Something, Say Something" and the "Personal Rights" postings were posted in a common area. The cleaning supplies and sharp items were kept locked and inaccessible to the residents. There was a designated space for the residents and staff files. Medications : The medications were, locked, and inaccessible to the residents. The overall facility is clean, and the furniture is in good condition. The facility air conditioning 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 were a variety of food types. Dishes and utensils are in sufficient supply and stored properly. Care & Supervision : Facility has sufficient staff, two caregivers at the time of this visit, and the staff were attentive and engaging the residents. Records Review: The LPA reviewed four resident files, two staff files, and reviewed previous CCL forms. There were no Title 22, Division 6 Regulation violations observed and/or cited during todays visit. An exit interview was conducted and a copy of this report was given to the Administrator, Leena Dost.