Facility Evaluation Report

Licensing Program Analyst (LPA) Avelina Martinez made an unannounced visit to this facility to conduct an annual inspection on 10/10/2023 at 12:38 PM. LPA Martinez met with Ali Qureshi & Ysenia Mendoza and stated the purpose of today’s 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 and expires on 10/24/2024. The facility is licensed for four ambulatory clients. There are currently four clients who reside at this facility.

LPA Martinez toured the facility with Ali Qureshi & Ysenia Mendoza on 10/10/2023 at 1:20 PM.

LPA Martinez reviewed two employee and client files, and the files were maintained. In addition, LPA Martinez reviewed two medication files, and the files were maintained. The first aid kit is complete. The fire extinguishers, smoke detectors, and carbon detectors are in good repair. The emergency exit door is in good repair. The last fire drill was on October 1, 2023. The facility has a food and emergency kit, and has a natural disaster plan. The facility has an infection control plan. Also, the facility kitchen is sanitary, and has an adequate food supply. The laundry room is sanitary, and the appliances are in good repair. The facility water temperature measured at 105 degrees, and the facility temperature measured at 74 degrees. Clients bathrooms are sanitary. The facility has an area for activities, and the facility has a public telephone.

Based on this annual inspection on 10/10/2023, 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 held, and a copy of this report was given at the end of the visit.