Facility Evaluation Report

Licensing Program Analyst (LPA) David Marrufo conducted an unannounced Annual Inspection Visit and met with Dvawntre Lattimore .

During visit, LPA Marrufo toured the facility inside and out. LPA toured the kitchen area and observed locked drawers for cooking utensils and cleaning supplies. LPA observed a perishable food supply of at least two days and a non-perishable food supply of at least seven days. LPA reviewed the first aid kit and found it to be complete.

LPA toured the living room area, hallway, and three out of three bedrooms. Each bedroom had working lights and available bedding and clothing storage areas. LPA Marrufo tested the smoke and carbon monoxide detector system and found it to function properly when tested. LPA toured two out of two resident bathrooms. One bathroom did not have working lights. A staff told LPA Marrufo that there had been a repair order put in place for the non-functioning bathroom light and the single resident currently at the facility uses the other bathroom. The other bathroom had functioning lights. LPA tested the water temperature in the bathroom and found the water temperature to be 114 F.

LPA toured the outside area and found the exits to be clear of obstructions.

LPA observed the resident records for R1, including the the Centrally Stored Medication and Destruction Records, Personal and Incidental Money Log, and Resident Record and found them to be complete. LPA reviewed staff records for five staff and found them to be complete.

An Advisory Note was issued. See LIC9102 for more information. No deficiencies were cited at this time as per California Code of Regulations Title 22. This report was reviewed with Dvawntre Lattimore and a copy of this report was provided.