Senior Care Records.

Facility Evaluation Report

Momentum Work, INC. Lakeside, Santa Maria12/03/2024Licence 425850008

Capacity4
Census1
Date signed12/03/2024 01:52:05 PM
The inspector’s account

On 12/03/2024, Licensing Program Analyst (LPA) Brian Phillips arrived at the facility above to conduct an unannounced evaluation visit. When the LPA arrived, they were greeted by Program Manager Griselda Escamilla. LPA informed facility representatives of the reason for the visit upon entry. LPA was later greeted by Program Director Edward Maldonado.

The LPA toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. This is an Adult Residential Facility (ARF). This facility is approved for a maximum capacity of four (4) clients. All clients are licensed and approved for ambulatory status. Facility has installed outdoor security/surveillance cameras in the front yard/driveway area.

The LPA inspected the food service areas in the facility and observed that items which could constitute a danger to clients are kept inaccessible to clients in the kitchen area. All appliances were in operable condition and looked clean/in good repair. Appliances such as microwaves, refrigerators, stoves, etc. are clean and operating properly. Food utensils, dishes, glasses, etc. are clean and in good repair with no cracks or chips. There is enough tableware and utensils for all clients living in the facility, and enough equipment for the storage, preparation, and service of food. LPA observed an appropriate/adequate amount of perishable and non-perishable food items maintained in the facility. Furniture is room/resident appropriate, clean and in good repair. All rooms are appropriately furnished for their intended use such as bedrooms, common areas, etc. Hot water temperature is maintained at Community Care Licensing (CCL) Title 22 regulations. Outdoor activity spaces have shaded areas and furnished for outdoor use. Each client has an adult bed with a mattress, pad, bedsprings, and pillow, which are clean and in good repair. Each bed is fitted with sheets, pillowcase, blankets, and bedspread that are clean and in good repair. Each resident has adequate dresser and closet space for clothing and other belongings that includes at least two drawers or adequate dresser space. The facility has a sufficient supply of linens to permit weekly changing or more often to always ensure clean linens for clients. Equipment and supplies for resident personal hygiene is available and on site. Continued on 809-C

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction