Facility Evaluation Report

Licensing Program Analysts(LPA) Santino Fortes and Manuel Monter conducted an unannounced annual inspection, and met with Care Giver(CG) Comfort Mensah. CG stated that facility has 3 staff and 5 clients.

LPAs toured the facility inside out including: kitchen, living room, and 1 staff area, 5 resident rooms and 2 restroom. Restrooms observed to have non skid flooring. LPAs observed perishable food supply of at least two days and non-perishable food supply of at least seven days. Refrigerator temperature was observed at 36 degrees F and Freezer temperature was 0 Degrees F. The front yard and backyard of the facility was also inspected. There was no obstruction to block the outdoor exits. LPA observed a box of garbage containing an old garden hose and broken wood in the rear side yard. CG disposed of the garbage during our visit. The garage was observed to be used as a supply storage area. LPA observed Facility License and Resident Personal rights were posted.

LPA observed the medication storage area, knives storage area, and cleaning product storage area as locked and inaccessible to clients in care. Room temperature was at 71.7 degree F, and hot water temperature was measured from resident bathroom at 119.1,117.5 degrees F. LPA inspected the facility first aid kit and it was observed to be complete. The facility was equipped with smoke and carbon monoxide detectors and sprinkler system. All smoke detectors functioned properly when tested. Fire extinguishers were last serviced on 12/26/24. The facility conducted their last fire drill on 11/29/24.

LPA reviewed facility records for 3 staff and 3 clients and were observed to be complete. LPA reviewed 3 clients medications, centrally stored medication records, resident P&I funds and they were observed to be accurate.

No deficiencies were cited during today's visit as per California Code of Regulations Title 22. Exit interview was conducted with CG Comfort Mensah. Report was reviewed and a copy was provided to CG for signature.