Facility Evaluation Report

At approximately 09:45 AM, Licensing Program Analyst (LPA) Star Stevenson arrived unannounced to CONTINUE a required 1-year annual inspection and was greeted by caregiver Carolina Ramos who has Designation of Facility Responsibility (RP) RP called House Manager Charmaine Infante (HM). HM arrived at approximately 10:10 AM to further assist with the continued annual inspection.

LPA was advised that three (3) of four (4) clients were away at day programming, while one (1) client was present during today's continued inspection.

At approximately 10:10 AM five (5) staff files were reviewed and 5 of 5 had all required documentation as required by title 22 regulations.

At approximately 10:35 AM LPA reviewed P&I monies with HM and observed the resources to be secure and their record to be accurate.

At approximately 10:55 AM LPA observed medicines to be centrally stored and secure and their administration accurate.

LPA obtained a copy of appropriate LIC400 Affidavit for Client Cash Resources, updated LIC500 Personnel Roster and updated LIC610D Emergency Disaster Plan.

No Deficiencies are cited. Signature of HM denotes receipt.