Facility Evaluation Report

Licensing Program Analyst (LPA) Steve Chang conducted an annual inspection visit, and met with House Manager (HM) Olivia Lazo. LPA observed 2 staff in the facility and all 5 residents went to day program.

LPA reviewed 3 residents files and 3 staff files.

LPA toured the facility inside out with HM. Licensee, personal rights posters and administrator certificate were observed at the entrance. LPA inspected family room, kitchen, dinning area, and laundry room. Medication closet, knives closet, and cleaning product closet were observed locked. There are 4 rooms for residents, and one staff live-in room in facility. 3 bathrooms are in facility. Room temperature was observed at 72 degree F, and hot water temperature was observed at 115 degree F. 2 days perishable food supplies and 7 days non perishable food supplies were observed sufficient.

The facility is equipped with smoke and carbon monoxide detectors. The facility equipped with fire alarm. HM tested the fire alarm, and smoke and carbon monoxide detectors, and they were working fine. The fire extinguishers were observed on service on 01/10/2024. Non skid mats were observed in the bathrooms. First aid box, flash light were observed in the facility.

LPA inspected the backyard, there was no obstruction to block the walkway. LPA observed two rooms at the backyard, HM stated both rooms are storage rooms.

LPA checked the log for fire and emergency drill, the last drill was conducted on 1/27/2024.

No citation was issued today. Exit interview was conducted with HM. This report was provided to HM for signature.