Facility Evaluation Report

Licensing Program Analyst (LPA) Ruth Wallace conducted unannounced Post Licensing Inspection Visit. LPA explained the purpose of the visit with administrator.

LPA Wallace and administrator inspected the physical plant including but not limited to four resident bedrooms, two resident bathrooms, kitchen, garage, shed and backyard area. This facility is a single story building licensed to serve six (6) ambulatory residents .LPA observed the facility to be free of odor, clean and in good repair. LPA observed sufficient furniture and lighting throughout the facility. There are no bodies of water present. LPA observed sufficient seven day non-perishable and two day perishable food supplies. Hot water temperature was measured at degrees Fahrenheit. There was cautionary signage posted in the bathrooms in regard to the hot water . Smoke and carbon monoxide detectors are in compliance with fire safety. Thermostat observed at (75) degrees Fahrenheit.

LPA observed centrally stored medications, toxins and sharp knives kept locked and inaccessible to clients. LPA reviewed resident and staff roster. LPA reviewed staff associations to the facility. First aid kit was checked and is complete. Required signage was posted as appropriate. Screening logs were reviewed and adequate. LPA reviewed one (1) resident file and one (1) one staff member files. All staff are fingerprint cleared and have current first aid certificates. All residents have required documents for community care licensing (CCL).

Per California Code of Regulations, Title 22, Division 6, Chapter 8, no deficiencies were observed during this visit.

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