Facility Evaluation Report

At approximately 11:20 AM, Licensing Program Analyst (LPA) Julie Florio arrived unannounced to conduct a required 1-year annual inspection and follow up on two special incident reports (SIRs) received by CCL on 6/15/2024 and 6/22/2024 and was greeted by Staff 1 (S1), Staff 2 (S2), and Staff 3 (S3). Virginia Punzalan, Designated Responsible Party (RP) was contacted and arrived at approximately 11:45 AM. Facility is an Adult Residential Facility with three (3) ambulatory clients in care. LPA was informed that Client 1 (C1) no longer attends Day Program and was present during today's inspection. LPA was informed that Client 2 (C2) and Client 3 (C3) were away at Day Program were and not present during today's visit. Facility is vendorized with North Bay Regional Center (NBRC).

At approximately 11:50 AM, LPA initiated a tour of the facility with RP 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 all of the 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, as well as an emergency water supply. LPA advised RP to increase the amount of fresh fruit and vegetables available to clients in the facility. Medications were centrally stored and locked. There is a shaded area in the backyard with outdoor space for activities. LPA was informed that the clients discuss where they would like to go for weekend outings during the week and decided collectively on a weekly basis which activities to plan. LPA observed a laptop available to clients in care. Facility has internet available to clients in care and the phone was tested an operational during today's inspection.

Facility's fire extinguisher was observed charged and was last serviced May 2024. Smoke and Carbon Monoxide detectors were tested and operational during inspection.