Facility Evaluation Report

Licensing Program Analyst (LPA) Marcela Yanez conducted an unannounced Required 1 Year visit and met with Shirley Capati House Manager LPA announced the purpose of the visit and observed 6 residents and 2 staff. ADM was called by House Manager and voicemail was left and no return call.

During visit, LPA toured the facility inside and out. LPA toured the garage area and observed food storage areas and locked cabinets for cleaning supplies. LPA observed the kitchen area and observed locked cabinets for medications, sharp objects, and cleaning supplies. Refrigerator temperature was measured with thermometer at 35 degrees F and freezer at 0 degrees F. LPA observed perishable food supply of at least two days and a non-perishable food supply of at least seven days. During tour of kitchen LPA observed an unlocked drawer with knives under a grocery bag accessible to residents in care.

LPA toured three resident bedrooms. Each bedroom had available bedding and clothing storage areas as well as functioning lights. Staff S1 tested the smoke detectors in the hallway found the smoke detector to function properly when tested. LPA toured two out of two resident bathrooms. Each bathroom had available soap and paper towels and functioning lights. The water temperatures in the bathroom sinks measured with thermometer at 114 to 115 degrees F.

LPA toured the outside area and found the exits to be clear of obstructions. LPA observed fire extinguisher was last serviced on 1/24/25 LPA reviewed Fire and Earthquake the last disaster drill was last conducted on 01/20/25.

LPA reviewed resident records for 3 residents. LPA reviewed 3 staff records House Manage reviewed the Centrally stored medication and P & I.

Deficiencies were cited as per California Code of Regulations Title 22. This report was reviewed with House Manager Shirley Capati and a copy of this report and appeal rights were provided.