Facility Evaluation Report

LPA Audrey Jeung toured facility and grounds, including detached storage shed in backyard. No accessible bodies of water or fire safety hazards are observed. There are 2 private bedrooms, a large shared bedroom, a vacant bedroom, two private bathrooms, a common bathroom, living room, and kitchen. In the 2 car garage, there is a washer and dryer, and storage cabinets. PPE and food supplies are adequate. Toxins and sharps are stored appropriately and inaccessible to clients, a comfortable temperature is maintained, and lighting is sufficient for comfort and safety. Soap and paper towels are present in bathrooms and kitchen sink. Toilet and bathing facilities are equipped with grab bars and nonskid flooring material. First-aid kit is inspected and complete. A Disaster and Mass Casualty Plan is posted. There are 4 residents present, and 2 staff. Criminal record clearances or exemptions for facility staff or other individuals who have client contact have been reviewed, as well as other staff records. Elizabeth Macharia is a certified ARF administrator (x 3/26) that oversees facility operations. Client records are reviewed. All residents are over the age of 60. Facility has an approved medical waiver to practice Christian Science, and does not handle medications, nor is required to maintain medical assessments for clients and staff.

The following forms/information are requested to be submitted to CCLD BY 5/28/25:

• LIC 308 Designation of Administrative Responsiblity

- LIC610D Emergency Disaster Plan (9 page, signed and dated)

Deficiencies of the California Code of Regulations, Title 22, Division 6, are cited on following pages. See also Technical Advisory Notes--3 pages.