Facility Evaluation Report

At 11:35 AM, LPA T. White arrived unannounced to conduct a required 1-year Annual inspection. LPA met with Administrator, Crystal Hedrick. LPA explained the purpose of today’s inspection. LPA was allowed entry into the facility that is licensed to serve a total capacity of 6 clients.

LPA toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature for clients is maintained at 68 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the clients. Hot water temperature in the shared clients’ bathroom was measured at 113.4 degrees Fahrenheit. All toilets, hand washing, and bathing are safe, sanitary and in operating condition. There is a minimum of 7-day nonperishables and 2-day perishables foods.

Smoke detectors and carbon monoxide were in operating condition during inspection. Fire extinguisher was last serviced on March 03, 2021. Emergency Disaster Plan was last posted on 03/03/2021. Mitigation observed to be complete. First aid kit was observed to be complete. Fire drill was last conducted on 02/10/2022.

The following forms to be updated and submitted to CCLD by 03/04/2022 :

LIC 308 Designation of Administrative Responsibility

LIC 400 Affidavit Regarding Client/Resident Cash Resources

Per the California Code of Regulations, Title 22, Division 6, Chapter 8, no deficiencies observed or cited.

Exit interview conducted with Administrator, copy of report given.