Facility Evaluation Report

At approximately 09:45 AM, Licensing Program Analyst (LPA) Stevenson arrived unannounced to conduct a required 1-year annual inspection and was greeted Residential Director Patricia Paiz. Facility is an Adult Residential Facility with Developmentally Disabled Clients in care. LPA was informed that there are four (4)-clients in care; with 1 client on an outing and another away at day programming. Room #3 is noted to be the only room capable for a non-ambulatory client by LIC602

At approximately 10:15 AM, LPA initiated a tour of the facility with Residential Director 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 was noted to have a well stocked supply of a variety of foods. Medications were centrally stored and locked. There is a large covered patio and seating area in the backyard with outdoor space for activities. LPA observed a supply of games for clients, a facility laptop available for client use, and an activity schedule. Facility has internet available to clients in care.

A main dinning table was noted to have a sticky film like a syrup or jelly and licensee was advised of the requirement that surfaces such as floors, chairs, toilets, sinks, counters and tabletops shall be cleaned and disinfected on a regular basis to ensure they are safe and sanitary and a Technical Advisory for CCR 85095.5(a)(2)(A) was issued.