Facility Evaluation Report, 09/21/2023 — Kellys Family Care, Fairfield CA

On 9/21/2023, Licensing Program Analyst (LPA) Tobola conducted an unannounced Annual Required – 1 yr. Inspection for this facility and was greeted by Lead Staff, Dysha Cupid. The facility Administrator, Regyna Jackson-Brandcomb was contacted and arrived later in the visit. The facility currently provides care for 5 clients, 3 of which were attending day program and 2 of which were present at the time of visit. LPA continued with a tour of the facility with staff. Client’s bedrooms, common areas, kitchen & food storage areas were inspected. Fire Extinguisher was found to be last charged on 8/26/2023. Smoke and carbon monoxide detectors were found throughout the facility, tested and found to be in working order. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. Food stored in the kitchen refrigerator were stored properly as per regulations on this day at the time of the visit. Water at faucets accessible to clients was measured at 112.2 degrees F which is within Title 22 Regulations. Shed located in the backyard stores landlords items and was found to be secured. Emergency exit located in the backyard was also found to be unobstructed.

Facility conducts and records emergency disaster drills on a monthly basis. Medications are located in a designated cabinet located in the kitchen and found to be secured. A spot medication count was conducted for clients and found to be in order. LPA found that the facility is not consistently receiving printout centrally stored medication records (CSMR) from the pharmacy. LPA recommended for facility to printout blank CSMR form to reconcile prescription information when needed. Technical Assistance issued. LPA conducted a review for staff files and found all staff to have 1st Aid & CPR certification and annual training on file. In addition, LPA reviewed all client records and found all documents including Needs & Service Plan, North Bay Regional Center Individual Program Plans and Physician's Reports to be current.