Facility Evaluation Report

LPA Audrey Jeung toured facility and grounds, including 2nd floor staff quarters and attached garage. Clients reside on ground floor, where there are 5 client bedrooms, staff room, 2 full bathrooms, 2 half bathrooms, kitchen, dining/living space and pantry. Upper level for staff consists of 2 bedrooms and bathroom. No accessible bodies of water or fire safety hazards are observed. Medications, toxins and sharps are stored appropriately and inaccessible to clients, a comfortable temperature is maintained, and lighting is sufficient for comfort and safety. Toilet and bathing facilities are equipped with grab bars and nonskid flooring material. Liquid soap is available at all sinks. Hot water temperature is tested at 115 degrees in main bathroom. Food supply and first-aid kit are inspected. A Disaster and Mass Casualty Plan is posted. There are 5 residents present, and 4 staff. Criminal record clearances or exemptions for facility staff or other individuals who have client contact have been reviewed, as well as staff records. Elena Madriaga is a certified RCFE administrator (x 11/24) that oversees facility operations. Client files are reviewed, including medications, which are recorded on Centrally Stored Medications Records.

The following forms are requested to be updated and returned to CCL by 5/7/24:

• LIC 308 Designation of Administrative Responsibility

• LIC 610D Emergency Disaster Plan (9 pages)

No deficiencies of the RCFE California Code of Regulations, Title 22, Division 6, Chapter 8 are observed. See Advisory Notes--8 pages--for technical violations to be addressed.