Facility Evaluation Report

LPA Audrey Jeung toured facility and grounds of this four bedroom home. There are 3 shared client bedrooms and a staff room, two common bathrooms, small living room and eat in kitchen. The yard is spacious, level, and fenced. Washer and dryer are located in two car garage There are no accessible bodies of water nor fire safety hazards observed. carbon monoxide detector is operable. Food supply and first-aid kit are inspected, and hygiene items for general use are maintained. Criminal record clearances or exemptions for facility staff or other individuals who have client contact have been reviewed, as well as required staff records. Evelyn Canonizado is a certified ARF administrator (x 12/26) that oversees facility operations. Client files are reviewed, and Centrally Stored Medications Records are maintained. Two clients are over age 60, and staff are advised that annual MD reports and appraisals must be maintained.

Personnel Report (LIC500) is requested to be updated and sent to CCLD by 2/11/26.

Deficiencies of the California Code of Regulations, Title 22, are cited on following pages. See also Technical Advisory Notes issued--2 pages.