Facility Evaluation Report

On 5/9/2024 Licensing Program Analysts LPA's) Tobola and Florio conducted a pre-licensing inspection and was greeted by Licensee Applicant, Nina German & Jethro Nicolas. This pre-licensing inspection is being conducted for an initial licensing. Fire Clearance has been approved for 4 non-ambulatory clients. Licensee Applicant is currently in partnership with North Bay Regional Center and in the process of starting vendorizing for client placement upon issue of license.

LPA conducted a tour and inspection of the indoor and outdoor portions of the facility. Facility was found to be clean and comfortable temperature with bedroom doors free from obstruction. LPA's observed Fire extinguishers throughout the facility were found to be recently serviced on 2/28/2024. Smoke detectors and carbon monoxide detectors were tested in common areas and client bedrooms all of which were found to be interconnected, tested and in working order. Emergency exits along the one side of the facility have appropriate hardware and found to be unobstructed. Water was measured between 113.5 & 115.1 degrees F in faucets used by clients which falls within regulation between 105 & 120 degrees F.

There was an ample supply of linens with appropriate bedding equipped in client rooms. An additional supply of hygiene, continence and paper products are located in a secured cabinet in client bathroom. Hallways are equipped with night lights for accessibility and client bedrooms have appropriate furnishings. There is a sufficient amount of dishes and cooking supplies for client use with sharps and other hazardous items kept secured in various designated drawer and cabinets as well as under the kitchen sink. Cleaning products and other toxins and chemicals are kept out of client access and found secured in the garage and kitchen area. LPA's observed adequate supply of both perishable and non-perishable food sufficient for the 4 clients in care. The facility will be conducting weekly grocery replenishment with consideration to client preferences and dietary restrictions. A sample menu will be posted in common area to indicate a healthy and balance set of meals for clients in care. The facility has a working phone landline on site with internet services for client use. Licensee applicant also purchased internet accessible electronic device for client use during the visit with receipts provided. Continued onto LIC809-C