Facility Evaluation Report

At approximately 09:45 AM, Licensing Program Analyst (LPA) Star Stevenson arrived unannounced to conduct a required 1-year annual inspection and was greeted by caregiver Mark Kho who has Designation of Facility Responsibility (RP) who called licensee/administrator Anny Camerino, who arrived at 10:10 AM. Facility is a Residential Care Facility for the Elderly (RCFE) with four (4) residents in care, three (3) of which are present and one (1) away at day program. Facility is vendorized with the North Bay Regional Center (NBRC).

At approximately 10:20 AM, LPA initiated a tour of the facility with Licensee and observed the following: Facility is a one story home, was a comfortable temperature, without odors and passageways were free from obstructions. Water temperatures in Residents' bathrooms measured within the allowable range of 105 to 120 degrees F per Title 22 regulations. LPA observed a supply of clean linens, paper products, and incontinent care briefs available to residents. Residents' bedrooms were inspected and observed to be clean, have appropriate furnishings as outlined in Title 22 regulations. Cabinets containing cleaning supplies and other items that could pose a risk were locked. Facility has at least two days of perishable food and one week of non-perishable foods. LPA observed one (1) instance of expired canned food and a technical violation was issued. LPA observed an emergency water supply, as well as, a 124 serving of emergency dry food. Medications were centrally stored and locked. There is a covered seating area in the backyard with outdoor space for activities. LPA observed the locked contents of sheds on either side of the house to be full of additional care supplies and tools. Licensee states that each resident has their own internet access device. Facility has internet available to residents in care and the phone was tested an operational.

Facility's fire extinguisher was observed charged and was last serviced 08/2025. Smoke and Carbon Monoxide detectors were tested and operational during inspection. Facility conducts quarterly disaster drills with the most recent drill conducted 09/2025.