Facility Evaluation Report
On 10/30/2024, at 9:20am, Licensing Program Analyst (LPA) Haner-Tomasko arrived unannounced to the facility to conduct the annual inspection visit. LPA met with Licensee Abiy Tesfazgy, announced who he is and the reason for the visit.
LPA and Administrator conducted a walking tour of the physical facility. The facility is located in a rural location and has a well for water, sceptic tank for plumbing, and electricity is powered by grid electricity. The front grounds are larger with areas for sitting and tables with covered porch for shade. There are walking areas for the residents in the front of the facility. The backyard is large and enclosed by a fence with self-latching gates on both sides of the yard. The facility has 10-bedrooms, 3 bathrooms, a large kitchen, large living room, dining room. There is a staff office. The facility has battery operated and wired smoke detectors in each room that were inspected by Alpha Fire Inspection on 12/3/2024. LPA observed fire extinguishers throughout the facility that were tagged current and in the green compression range, serviced on 11/20/2024. LPA tested facility hot water at 105*(f), within regulation temperatures 105*-120* (f). LPA observed at least 2 - days of perishable and at least 7 - days of nonperishable foods. During the facility tour in the kitchen at 9:30am LPA noted approximately nine steak knives in the designated knife drawer and the magnetic lock broken and not functioning. At 9:32am LPA observed four lighters in a drawer next to the kitchen sink in an un-lockable drawer. At 9:58am the lockable door to the laundry room was noted to not close completely and the striker not lining up with the strike plate preventing the door from locking. Unlocked chemicals and paint were noted inside the Laundry room. LPA was unable to complete the facility annual and may return at a later date.
LPA and Administrator conducted a partial review of the annual care tool modules.
Exit interview conducted, deficiency cited on LIC809-D, report signed, and report provided to Administrator.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction