Facility Evaluation Report

On 12/11/23, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct an annual visit.

introduce self, stated the purpose of the visit, and requested to meet with the Administrator. LPA met with staff Natividad Barbadillo. Staff was unable to reach Administrator. LPA toured facility with staff. One client was present upon LPA arrival and left on outing during inspection.

The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside or outside. An adequate supply of perishable and non-perishable food was observed. Refrigerator temperature was maintained at 22 degrees F and freezer at -10 degrees F. Medications were observed locked in cabinet in dining area. MARs were reviewed. Fire extinguisher was observed with a purchased date of: 1/24/23. Cleaning supplies and chemicals stored in garage cabinet. Bleach bottle and detergent was observed unlocked in the garage.

All bedrooms were observed to have the required furnishings and with adequate lightening . LPA and staff observed a medication cream in bedroom 3 unlock. The bathrooms were properly equipped and operating. Hot water temperature was tested at 110.2 degrees F in bathroom.Outside of facility toured and observed to be free of debris . At approximately 1:32 PM, LPA and staff observed side gate locked. Gardening tools was observed under outdoor seating unlocked.

All clients’ files were reviewed to have all the required documents. Sample of Staff files were also reviewed and observed to have all required documents. Carbon monoxide and smoke detectors were tested and observed to be operational.

A deficiency is being cited on the attached Lic 809D in accordance to California Code of Regulations, Title 22, Division 6.Exit Interview conducted. A copy of this report and appeal rights was provided to staff, whose signature on this form confirms receipt of this report.