Facility Evaluation Report

Licensing Program Analyst (LPA) Audrey Jeung toured facility and grounds, consisting of three shared client bedrooms, two staff rooms--one with a large bed for 2 staff and the other with no bed--two full bathrooms, dining area, TV room, kitchen and living room. A comfortable temperature is maintained and lighting is sufficient for comfort and safety. This is a single story facility with one car garage, where washer and dryer are located. Water temperature is tested in main bathroom. Medications, sharps, and chemicals are observed locked and inaccessible to residents. Food supplies of perishables for 2 days and non-perishables for 7 days are maintained. First aid kit is observed to be complete. Carbon monoxide detector is tested and operable. There are 4 residents present, and 3 staff.

Client records and staff records are reviewed. Ana Marie Avevalo and Jocelyn Maniva are certified RCFE administrators (x 7/26 and x 3/27) that oversee facility operations. Centrally Stored Medication Records will be reviewed at a later date, due to time constraints. Emergency drills are documented as conducted quarterly.

The following information/forms are requested to be submitted to CCLD BY 7/7/26:

- Medication training requirements for staff, as per Health and Safety Code 1569.60

- updated Facility Sketch, showing room designations

Deficiencies of the California Code of Regulations, Title 22, are observed. See Technical Advisory Notes --4 pages. Report is reviewed with administrator and a copy is provided.