Facility Evaluation Report

Licensing Program Analyst (LPA) Ruth Wallace conducted an unannounced required annual inspection visit. LPA met with licensee and explained the purpose of the visit.

LPA and licensee inspected the physical plant including but not limited to the kitchen, resident bedrooms, staff room, two resident bathrooms, laundry area, and backyard area. LPA observed the facility to be free of odor. 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 112.5 degrees Fahrenheit in resident bathroom sink, which is within the required range of 105 to 120 degrees.

Fire extinguishers were last inspected on 8/16/23. Smoke detectors are current and in compliance with fire safety. LPA observed centrally stored medications and toxins are kept locked and inaccessible to residents.

LPA reviewed and compared resident medication vs. resident medication logs. LPA reviewed two resident and three staff files, including criminal record clearances. All staff are fingerprint cleared and associated to the facility. First aid kit was checked and is complete. Fire drill was conducted on .

LPA received the following updated document on today's date: LIC 308 - Designation of Administrator, LIC 500 - Personnel Summary, copy of administrator's certificate, and copy of surety bond

Per the California Code of Regulations, Title 22 no deficiencies were observed or cited.

Exit interview held with licensee. A report and LIC 811 (Confidential Names) was left at the facility