Facility Evaluation Report

Licensing Program Analyst (LPA) Ruth Wallace conducted unannounced Required 1 Year Annual Inspection Visit. LPA met with administrator and explained the purpose of today’s inspection. LPA was allowed entry into the facility that is licensed to serve a total capacity of 46 ambulatory clients.

LPA and administrator toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area and side yard. 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 72.6 degrees Fahrenheit. Hot water measured at 110.4 degree Fahrenheit in resident's shared bathroom which is within the required regulation of 105 to 120 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the clients. All toilets, hand washing, and bathing are safe, sanitary and in operating condition. There is a minimum of 7 day non-perishable and 2 day perishables foods. LPA observed smoke detectors are interconnected with the fire department. LPA observed carbon monoxide in operating condition during inspection. Fire extinguishers were last serviced on 1/10/2022. LPA observed completed mitigation plan. LPA reviewed six (6) resident and four (4) staff files, including criminal record clearances. Three staff were missing current first aid certificates. Fingerprint clearance and associations to the facility. First aid kit was checked and is complete.

LPA requested the following forms to be submitted via email by February 6, 2023:

LIC 308, LIC 610-D, Surety Bond, and Administrator Certificate.

See deficiency cited from the California Code of Regulations, Title 22, and California Health and Safety Code.

Exit interview held with Administrator and a copy of report given at the conclusion of the visit.