Facility Evaluation Report

Licensing Program Analyst (LPA) Albert Johnson conducted an unannounced annual/random visit on this date. LPA met with Avinesh and explained the purpose of the visit.

LPA with Staff inspected physical plant including but not limited to kitchen, bedrooms, bathrooms, living and dining room area. LPA observed sufficient furniture and lighting throughout the facility. LPA observed sufficient seven day non-perishable and two day perishable food supplies. Hot water temperature was measured at 116.5 degrees Fahrenheit in resident bathroom sink, which is within the required range of 105 to 120 degrees. Fire extinguishers and smoke detectors are current and in compliance with fire safety. Carbon dioxide monitor present.

LPA observed centrally stored medications locked inside the medication cabinet.

LPA with the assistance of Administrator reviewed and compared resident medication vs. resident medication logs. LPA, Staff and Administrator reviewed 3 resident and 2 staff files, including criminal record clearances. During the file review the physician's report for R1 was not in the file. All staff today are Fingerprint cleared and associated to the facility. First aid kit was checked and is complete.

Per California Code of Regulations, Title 22 Division 6, Chapter 8 and Health and Safety Code, deficiencies were cited on the 809D attached during this visit. Exit interview held and a report given at the conclusion of the visit.