Facility Evaluation Report

At approximately 1:05 PM, Licensing Program Analyst (LPA) Star Stevenson arrived unannounced to BEGIN a required 1-Year annual inspection and met with house manager/caregiver Angelie Dean who called Administrator Princess Diana Silverio, who, by phone reported Angelie Dean has Designation of Facility Responsibility(RP) and could help with today's inspection. LPA was informed there are four (4) residents in care with three (3) residents away in day programming and one (1) resident home.

Facility is a Residential Care Facility for the Elderly (RCFE) that has vendored residents from North Bay Regional Center (NBRC). Facility has a hospice waiver for three (3), an approved dementia plan and fire clearance for capacity of six (6) residents; five (5) non-ambulatory and one ambulatory. Bedroom #6 is approved for an ambulatory resident only and is currently being used by a staff member.

At approximately 1:25 PM, LPA initiated a tour of the facility and observed the following: Facility is a one-story home, was a comfortable temperature, without odors 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 client showers with grab bars and non-slip mats as required. LPA observed a supply of clean linens, incontinent care products, and paper products available to clients. Clients' bedrooms were inspected and observed to have appropriate furnishings as outlined in Title 22 regulations. Cabinets in communal areas containing cleaning supplies and other items that could pose a risk were observed locked. Facility has sun and shade areas in backyard for clients and a large shed was observed to be locked with additional supplies.

Staff rooms containing personal medicines and valuables were locked with keypads to make compliance with locking staff doors easier.