Facility Evaluation Report

On 05/07/2024, Licensing Program Analyst (LPA) Jaynae Boyles, arrived at the facility unannounced to conduct a 1-Year Required Annual Inspection. LPA met with the house manager and explained the purpose of the visit.

LPA Boyles and house manager toured facility together to ensure health and safety of residents in care. LPA observed the facility to be clean, in good repair and odor-free. In the areas toured no immediate health, safety, or personal rights violations were observed.

Areas toured include but are not limited to: common areas, resident bedrooms, garage, backyard, and common restrooms. LPA observed each bathroom to have the necessary grab bars, non-skid flooring or shower chair, paper towels, trash can with lids and 20-second hand-washing poster. LPA observed all of the resident bedrooms to have all the required furnishings, working lights and windows with screens.

Facility has a 2-day perishable and a 7-day non-perishable amount of food. Hot water temperature was measured at 115 F. LPA observed the sharps to be locked.

LPA observed one (1) fire extinguishers, fire detectors, and carbon monoxide detectors. LPA observed the first aid kit to be complete and ready for emergency use. LPA observed the emergency disaster plan to be complete with emergency disaster drills completed quarterly.

LPA observed chemicals stored accessible to residents in two locations within the facility.

LPA reviewed a total of four (4) residents' files and four (4) staff files. Resident files contained all the required documentation. One of four staff files reviewed were missing a completed medical assessment and TB test.

Deficiencies cited from Title 22 Regulations and or the California Health and Safety Code. An exit interview was conducted, and Plans of Corrections were reviewed and developed collaboratively. A

copy of this report, LIC 809-D, and Appeal Rights were discussed and provided .