Facility Evaluation Report

LPA Audrey Jeung toured facility and grounds, including two detached storage structures and an off-duty staff room, which includes a full bathroom and kitchen--but no stove. There two private and one shared client bedrooms--front room #1 is cleared for non-ambulatory clients. Room #3 is staff room, where there is a single bed and bunk beds. There are no accessible bodies of water nor fire safety hazards observed. A comfortable temperature is maintained and hot water temperature is tested in rear client bathroom. Food supply and first-aid kit are inspected, and hygiene items for general use are maintained, including PPE. Client files are reviewed, and medications are recorded on Centrally Stored Medications Records. Two clients' cash resources are reviewed. Disaster drills are documented and performed quarterly. Criminal record clearances or exemptions for facility staff or other individuals who have client contact have been reviewed, as well as other required staff records. Venerando Gano is a certified ARF administrator (x 10/27) that oversees facility operations.

The following forms are left with facility representative to be completed and returned to CCL by 1/13/26:

• proof of control of property (signed and dated lease agreement)

Deficiency of the California Code of Regulations, Title 22, is observed and cited on a following page. See also Technical Advisory Notes--2 pages.