Facility Evaluation Report
On 01/18/2024 at 10:45 AM Licensing Program Analyst (LPA) Avelina Martinez made an unannounced visit to this facility to conduct an annual required inspection. LPA Martinez met with Jeffrie Chairez and explained the purpose of the visit. LPA Martinez inspected the physical plant including but not limited to the kitchen, dining room, resident bedrooms; resident bathrooms, laundry room, activity room, and outside courtyards of the facility to ensure compliance with Title 22 regulations.
Administrator holds current certificate expires on 08/13/2024 The facility is licensed for 1 non-ambulatory client at bedroom 1 and 4 ambulatory clients. There are currently 4 residents who reside at this facility.
The LPA toured the facility with the Jeffrie Chairez on 01/18/2024 at 11:30 AM.
LPA Martinez reviewed three resident files and three staff files. The files were maintained and in order. LPA Martinez reviewed resident 1 (R1) medication file. R1's medication file was maintained. LPA reviewed P&I files. P&I Ledgers were maintained. LPA Martinez requested a copy of P&I surety bond. In addition, LPA Martinez requested P&I polices and procedures documents. LPA Martinez requested a copy of liability insurance. Please email requested document to LPA Martinez by 01/25/2024 by 5:00 PM.
Moreover, client bedrooms and bathrooms are furnished and sanitary. The facility has an area for activities and has a public telephone. The facility laundry area is sanitary, and is open for client use. The facility kitchen is sanitary, and the facility has an adequate food supply. The facility temperature measured at 72 degrees. The exterior of the facility is clear of debris, and emergency exit gate is in good repair. Carbon detectors, smoke detectors, and fire extinguishers are in good repair. The last fire drill was on 01/08/2024.
Based on observation, interviews, and record review, the facility is in compliance with California Code of Regulations, Title 22 and Health and Safety Code, there were no deficiencies cited at this time. An exit interview was conducted, and a copy of this report was provided to the facility.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction