Facility Evaluation Report

Licensing Program Analyst (LPA) R. Campbell and LPA Michael Bilger conducted an unannounced Annual 1-Year Required visit on this date. LPA met and toured with Ildefonso Letran, Assistant Administrator .

LPA toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 4 total bedrooms of which 3 bedrooms are occupied by the residents and 1 bedroom is occupied by staff. There are no bodies of water observed. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. A comfortable temperature is maintained at 76 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured between 105 and 120 degrees Fahrenheit. The fire extinguisher was last inspected on August 9, 2021 and all smoke alarms and carbon monoxide alarms were tested successfully. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of 7-day supply of nonperishable and 2-day of perishable foods.

LPAs observed the following deficiencies:

- The sharps drawer in the kitchen was unlocked.

- Large amount of recyclables, extra doors and chairs need to be cleared from backyard.

The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22 ,and California Health and Safety Code. Failure to correct deficiencies may result in civil penalties.

Exit interview conducted. Appeal Rights and a copy of this report provided.