Facility Evaluation Report

Licensing Program Analyst (LPA) Simi Rai conducted an unannounced Required 1 Year visit and met with Administrator Designee, Kathleen Anne Reboton. LPA Rai observed 2 staff and 2 residents at the facility since 3 residents were 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 observed 1 shed in the backyard which was locked and used for storage and not habitual space. 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 facilty to include 3 resident rooms, 1 staff room, living room, dining room, kitchen and garage. 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 hot water temperature in the bathroom and kitchen sink ranged from 119.3 - 119.5 degrees F.

Fire extinguisher was observed and inspected on 9/18/2024. Facility smoke detectors and carbon monoxide detectors were in working condition. The last disaster drill was conducted on 06/20/2024.

LPA Rai reviewed facility records for 2 staff and 2 residents. LPA Rai reviewed resident medications and central stored medication records.

No deficiencies were cited per California Code of Regulations, Title 22. This report was reviewed with Administrator Designee, Kathleen Anne Reboton. and a copy of the report was provided.