Facility Evaluation Report

At approximately 10:40 AM, Licensing Program Analyst (LPA) Star Stevenson arrived unannounced to conduct a required 1-year annual inspection and was met by DSP caregiver Josephina Calderon, who called Administrator Bessa Livica. Administrator Bessa arrived to the facility at approximately 11:05 AM. Facility is an Adult Residential Facility For Persons with Special Health Care Needs (ARFPSHN) with five (5) non-ambulatory clients in care. LPA was informed that four (4) of five (5) clients were present and one (1) client was in day program. Facility cares for two (2) clients with stage three (3) and/or stage four (4) pressure wounds that do not require exceptions from Community Care Licensing (CCL) due to their ARFPSHN license in California.

Both Ring doorbell and default doorbell were observed to be out of order and a technical advisory was issued to ensure a working doorbell was made available for visitors.

At approximately 11:20 AM, LPA initiated a tour of the facility with Administrator and observed the following: Facility is a one story home, was a comfortable temperature, and passageways were free from obstructions. Water temperature in clients' bathrooms measured within the allowable range of 105 to 120 degrees F per Title 22 regulations. LPA observed a supply of clean linens and paper products 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 does not have at least two days of perishable food, because, currently, 3 client have G-tubes and receive physician prescribed formulas as their sole source of nutrition. Facility does have one week of non-perishable foods, as well as an emergency water supply. LPA observed a supply of incontinent care goods for each of the clients.