Facility Evaluation Report

Licensing Program Analyst (LPA) Santino Fortes conducted an unannounced annual inspection, and met with Program Director (PD) Fernando Paz. PD stated facility has 2 staff and 13 clients.

LPA toured the facility inside and out. There were 8 resident rooms (shared), 2 staff break rooms, 1 living room, 1 dining room, and Kitchen. LPA observed resident rooms each with a chair, night stand, sufficient lighting and chest of drawers. Room temperature was 72.1 * F. Hot water temperature was Bathroom, 114*F, Bathroom 114* F and kitchen 115* F. LPA observed the first aid kit to be complete. Smoke and carbon monoxide detectors functioned properly when tested. 3 Fire extinguishers were serviced on 9/18/24. Staff conducted a fire drill on 3/1/25. Restrooms observed to have non skid flooring. LPA observed 2 days perishable food supply and 7 days non-perishable food supply. Refrigerator temperature observed at 33 * F and Freezer temperature -5* F. LPA observed medication storage, knives storage, and cleaning product storage rooms locked and inaccessible to clients in care.

The front and back yards of the facility were inspected. Exits and walkways were unobstructed. Facility has 3 small plastic storage sheds used to store facility equipment and home repair supplies..

LPA observed Facility License and Resident Personal rights were posted. LPA reviewed facility records for 3 staff, 5 clients and observed to be complete. LPA reviewed 5 client’s medications, centrally stored medication records and observed to be complete.

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