Facility Evaluation Report

Licensing Program Analyst (LPA) Santino Fortes conducted an unannounced annual inspection, and met with Caregiver (CG) Diosdado Zabal. CG informed that facility has 2 staff and 9 clients. Licensee (LC) was cooking dinner and residents were watching TV in the living rooms and their rooms. 1 resident was asleep.

LPA toured the facility inside out including: 2 kitchens, 2 living rooms, 2 staff room, 6 shared resident rooms and 4 restrooms. Restrooms observed to have non skid flooring. LPAs observed perishable 2 day food supply and non-perishable food supply of at least 7 days. Two Refrigerators temperature observed at 45* degrees F and 3 Freezer temperature were 0 Degrees F. LPA observed an outlet with a broken cover plate. New plate was installed during visit. The front yard and backyard of the facility was also inspected. LPA observed 2 bags of clothing in the hall, 2 boxes of empty clean food containers, pots, kitchen appliances throughout the house. Various bike parts were all around the yard and 2 mattresses were in the middle yard. There was no obstruction to block the outdoor exits. Basement is a storage for bikes and household items.

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 68 degree F, and hot water temperature was measured in 2 resident bathroom at 118* and 117* 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 all functioned properly when tested. Fire extinguishers were last serviced on 10/21/24. The facility conducted their last fire drill on in 2023.

LPA reviewed facility records for 3 staff and 8 clients. LPA reviewed 2 clients medications and centrally stored medication records and were complete.

Deficiencies were cited during today's visit as per California Code of Regulations Title 22. Exit interview was conducted with LC. This report was reviewed and a copy was provided to LC for signature.