Facility Evaluation Report

LPA Audrey Jeung toured facility and grounds of this 5 bedroom Adult Residential Facility for Persons with Special Health Care Needs. There are no accessible bodies of water nor fire safety hazards observed. All passageways are accessible. A comfortable temperature is maintained and lighting is adequate for safety. Hot water temperature is tested at 117 degrees in client bath/shower room. Food supply--consisting of formula and solid food--and first-aid kit are inspected, and hygiene items for general use are maintained. Four residents are dependent upon G-tube feeding for nutrition and hydration, and at least 7-day supply of formula is maintained. Client files are reviewed and complete. Medications are recorded on Centrally Stored Medications Records, and cash handling records accurately reflect cash safeguarded. Disaster drills are done quarterly and documented; the most recent was conducted 12/1/25. Criminal record clearances or exemptions for facility staff or other individuals who have client contact have been verified, and staff records are reviewed. Facility employs LVNs and RNs; their licenses are checked and valid. Direct care providers have current first aid training. Madonna Valencia is a certified ARF administrator (x 10/27) that oversees facility operations. There is no staff room, as facility employs awake night staff.

The following information is given to LPA today:

- Designation of Administrative Responsibility (LIC308)

No deficiencies of the CA Code of REgulations, Title 22, are observed today.