Facility Evaluation Report

Licensing Program Analyst Albert Johnson arrived unannounced to conduct a case management visit health and safety check.

There were two residents in care at this time.

The facility was inspected including but not limited to the kitchen, dining room, resident bedrooms; resident bathrooms, laundry room, living area, common TV area, and outside backyard of the facility to ensure compliance with Title 22 regulations. Facility is a 5 bed adult residential facility with a current census of 2.

LPA observed the facility to have adequate food supply. Resident rooms were sanitary and had the required furniture and furnishings. The facility common areas were clean and furnished. Smoke and carbon detectors were in good repair. Facility has an emergency food and water kit. LPA requested that the pet have a file with current information.

An exit interview was conducted with staff .