Facility Evaluation Report

Licensing Program Analyst (LPA) Kesha Lewis arrived at this facility unannounced to conduct an post licensing inspection visit. LPA met with the administrator Staci Stevens and explained the purpose of the visit.

LPA inspected the physical plant including but not limited to the kitchen, dining room, resident bedrooms; resident bathrooms, laundry room, living area, common TV area, and outside of the facility to ensure compliance with Title 22 regulations. Facility is a adult residential care facility (ARF) with a current census of 1. Facility has 16 beds and 2 bathrooms for resident use. Facility has a dining area off the kitchen. LPA also conducted the inspection using the CARE tool. Facility currently provides care for 1 ambulatory residents, 0 non ambulatory residents and 0 bedridden. The facility has an approved infection control plan in place. Water temperature reads 105*F to 120*F in the bathroom and room temperature reads 74*F. LPA observed the facility to have adequate food supply. Resident rooms were sanitary and had the required furniture and furnishings. The facility common areas were clean and furnished. Smoke and carbon detectors were in good repair. Fire extinguisher was checked 11-15-24. Facility has an emergency food and water kit. All toxins and other dangerous items including sharp objects were locked and inaccessible to residents in care. Medication storage area was observed to be locked and inaccessible to residents in care. First aid kit was observed to have adequate supplies and accessible to staff. The facility has a AED and Narcan.

During this inspection 1 resident files and 1 staff file were reviewed for regulatory compliance. All files contained required contents. Per California Code of Regulations, Title 22, no deficiencies were observed during this visit. Exit interview was held and a report was given to Administrator Staci Stevens.