Facility Evaluation Report

Licensing Program Analyst (LPA) Cheryl Goodrich conducted an unannounced annual visit. LPA met with the Caregiver Nestor Blay at the front door and was granted entry. The purpose of today’s visit is to inspect the facility to ensure that the facility follows California Code of Regulations, Title 22, Division 6. Facility is approved for five (5) ambulatory and non-ambulatory residents.

Physical Plant: front entrance, interior and surrounding exterior were clean and in good repair with no pathway obstruction; doorway alarms were in working order; residents' main restroom water temperature read at 119.1 degrees; there were no bodies of water on premises; there was sufficient lighting and mattress pads in all of the residents' bedrooms; fire alarm and smoke carbon monoxide detectors were in working order. Facility does not house firearms and/or ammunition on grounds.

Food Services : 7-day non-perishable and 2 day of perishable food supply was observed, and all food was properly stored and available to residents. No emergency food supply was observed.

Medication/Facility Records: Medications were observed to be labeled and in a locked place that is inaccessible to residents. All staff subject to a criminal record review obtained fingerprint clearance and/or an exemption.