Facility Evaluation Report

Licensing Program Analyst (LPA) Albert Johnson arrived unannounced to conduct an Annual Inspection. The LPA met with Staff.

The facility is an adult residential facility funded by Valley Mountain Regional Center with a current census of 6. Facility has 4 bedrooms and 3 bathrooms. Three bedrooms are for resident use. Facility has a formal dining area and a formal living room.

LPA and Staff inspected the physical plant to ensure the health and safety of the clients in care. LPA inspected the facility with Staff including but not limited to the kitchen area, resident rooms, bathrooms, dining room, and storage areas. The facility had the required carbon monoxide detectors. LPA observed the facility to be free of odor and clean. LPA observed sufficient lighting throughout the facility. Fire extinguishers and smoke detectors are current and in compliance with fire safety. LPA reviewed three (3) client files and two (2) staff files, including criminal record clearances. LPA observed centrally stored medications locked in then medication room. LPA reviewed and compared resident medication vs. resident medication logs. LPA reviewed resident and staff files, and interviewed both. All staff were cleared and associated to the facility. First aid kit was checked and is complete. No citations given.

Exit interview conducted. A copy of this report was left with the Staff.