Facility Evaluation Report

At approximately 12:15 PM, Licensing Program Analyst (LPA) Star Stevenson arrived unannounced to conduct a required 1-year annual inspection and was greeted by House Manager, Susana Quisquino who has a LIC308 (Designation of Facility Responsibility). House Manager contacted Administrator. Administrator, Perla V. Garcia arrived at approximately 01:30 PM

Administrator gave permission for House Manager to conduct the tour. Facility is an Adult Residential Facility with Developmentally Disabled Clients in care. LPA was informed that all four clients were away at their day programs.

Upon arrival three (3) staff members were present and one individual (I1) was working cleanind dishes and changing a client bed and was found to not be cleared on Guardian. A type A deficiency was assigned and a civil penalty in the amount of $500.00 is being assess due to a violation of CCR 80066(a)(12)(B)

At approximately 12:30 PM, LPA initiated a tour of the facility and observed the following: Facility was a comfortable temperature and passageways were free from obstructions. Water temperature in clients' bathrooms measured 117.7 and 116.2 degrees F, which is within allowable range of 105 to 120 degrees F per regulation. LPA observed a supply of clean linens available to clients. Clients' bedrooms were inspected and observed to have appropriate furnishings as outlined in Title 22 regulations. Cabinets containing cleaning supplies and other items that could pose a risk were locked. Facility has at least two days of perishable and one week of non-perishable foods. There is outdoor space for activities, and the facility plans weekly outings.

The facility is hardwired. Fire extinguisher was last serviced January 2024 and was fully charged. Smoke and Carbon Monoxide detectors were tested and operational during inspection.