Facility Evaluation Report

At approximately 1:00 PM, Licensing Program Analyst (LPA) Star Stevenson arrived unannounced to BEGIN a required 1-year annual inspection and was greeted by House Manager/Caregiver Maria Batungbakal Licensee/Administrator, Licensee Grace Acosta was called and acknowledged that Maria Batungbakal could help with the inspection. LPA observed 1 other Direct Support Professionals (DSP) present who was associated to the facility through Guardian.

Facility is an Adult Residential Care Facility with Developmentally Disabled Clients in care. Gannet Prime is currently caring for 2 clients, both of who were away in day programming during my visit.

At approximately 1:20 PM, LPA initiated a tour of the facility with House Manager Caregiver Maria Batungbaka.

During facility inspection, LPA observed the following: Facility was a comfortable temperature and passageways were free from obstructions. Water temperature in clients' bathrooms measured 110.4 and 111.1 degrees F, which is within allowable range of 105 to 120 degrees F per regulation. LPA observed a supply of clean linens, PPE and extra incontinence supplies available to clients.

LPA observed all occupied and vacant client rooms and determined they had the appropriate furnishings as outlined in Title 22 regulations.

Cabinets containing cleaning supplies, knives 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 and a supply of bottled water, as well as emergency supplies and flashlights. In addition, the facility has a back-up battery wall for emergency power.