Facility Evaluation Report

At approximately 10:15 AM, Licensing Program Analysts (LPAs) Julie Florio and Robert Frank arrived unannounced to conduct a required 1-year annual inspection and was greeted by Staff 1 (S1). Raquel Cistac, Designated Responsible Party (DRP) was contacted and arrived at approximately 11:15 AM. Facility is an Adult Residential Facility with three (3) ambulatory clients in care -- 2 were away at Day Program and 1 was present during today's visit. Facility is vendorized with North Bay Regional Center (NBRC).

At approximately 11:20 AM, LPAs initiated a tour of the facility with DRP and observed the following: Facility is a one story home, was a comfortable temperature, and passageways were free from obstructions. Water temperatures in clients' bathrooms measured within the allowable range of 105 to 120 degrees F per Title 22 regulations. LPAs 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. However, LPA's observed 3 dresser drawers missing knobs and 1 broken dresser drawer in Client 2 (C2's) bedroom and 1 briken dresser drawer in Client 1 (C1's) bedroom, (see LIC809D). Cabinets containing cleaning supplies and other items that could pose a risk were locked. However, LPA's observed a magnet to unlock the kitchen sink cabinet stored out in the open next to cabinet and inaccessible to clients in care, (see LIC809D). Facility has at least two days of perishable food and one week of non-perishable foods, as well as an emergency water supply. However, LPA's observed over 8 instances of expired food, (s ee LIC809D). Medications were centrally stored and locked. There is space in the backyard for activities. LPA s observed games and activites available for clients. LPAs observed an internet access device available to clients in care. Facility has internet available and the phone was tested an operational during today's inspection.

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