Facility Evaluation Report

Licensing Program Analyst (LPA) Simi Rai conducted an unannounced Required 1 Year visit and met with Staff Cindy Joyce and Staff Darren Ignacio. LPA Rai spoke with Administrator (ADM) Jean Berris over the phone and stated the purpose of the visit. ADM gave verbal authorization for Staff Cindy Joyce to sign the report on her behalf. LPA Rai observed 2 staff and 4 residents at the facility and 1 resident was attending day program.

During visit, LPA Rai toured the inside and outside of the facility. When touring the outside area of the facility, the exits were cleared of obstruction. LPA Rai toured the facility kitchen and observed food supply of at least 2 days of perishable food and at least 7 days of nonperishable food. Sharps and medications were locked in secured areas. LPA observed additional food supply areas and secured areas for cleaning supplies and laundry detergents.

LPA Rai toured the resident and staff bedrooms. 3 out of 3 resident bedrooms had available bedding, drawers, and functioning lights. The facility bathroom had available soap, paper towels, and trash cans with lids. The water temperature in the bathroom sink was 109.4F. The water temperature in the kitchen sink was 113.0F.

Fire extinguisher was observed and inspected on 03/08/2023. Facility smoke detectors and carbon monoxide detectors were in working condition. The last disaster drill was conducted on 12/30/2023.

LPA Rai reviewed facility records for 2 staff and 2 residents. LPA Rai reviewed resident's medications and central stored medication records. LPA Rai review resident's safeguard for cash resources.

No deficiencies were cited per California Code of Regulations, Title 22. This report was reviewed with Staff Cindy Joyce and a copy of the report was provided.