Facility Evaluation Report

On 6/9/2023, Licensing Program Analyst's (LPA) Tobola arrived announced to conduct a pre-licensing inspection and was greeted by Licensee Applicant, Dennis Ramas and Administrator, Jenna Baluyot. This pre-licensing inspection is being conducted as an initial facility application. Fire Clearance has been approved for 4 ambulatory and 1 non-ambulatory residents. There are currently 0 residents in care. The facility is a 5 bedroom 2 bathroom single story home.

LPA conducted a tour and inspection of the indoor and outdoor portions of the facility. Multiple fire extinguishers are located throughout the facility found to be charged on 6/6/2023. Smoke detectors and carbon monoxide detectors were present and all functional. Hot water measured between 110.6 & 111.9 degrees in faucets used by residents which falls within regulation between 105 & 120 degrees F. There was an ample supply of linens, dishes and cooking supplies. There was a sufficient supply of cleaning supplies and hygiene products available for residents. Facility is in the process of vendorization under North Bay Regional Center and prior to admission; facility will acquire appropriate food supply. Facility was found to be a comfortable temperature with all facility building and outdoor exits free from obstruction. Toxins and cleaning supplies were observed to be secured located in the garage. In addition, all knives and other sharp items were found to be in a designated locked drawer in the kitchen. LPA found facility hallways in need of floor/night-lights. Facility has purchased and will install. Photos to be sent to CCLD.

Medications will be centrally stored in cabinets located in a secured garage along with medication records. A second refrigerator is located in the garage for clients that may require refrigerated medication. Facility has prepared blank templates of all appropriate Licensing forms for incoming resident and staff records, all contained in a secured location. Required postings such as Rights to resident councils, client's rights and Complaint Poster are posted at the client common areas and visible to staff and clients.

LPA observed staff living/rest quarters located on the facility side yard. Facility sketch does not indicate staff living quarters however Licensee Applicant stated Fire Inspector is aware and has inspected the room. LPA is requesting for Licensee Applicant to update facility sketch and resubmit fire clearance inspection request for final approval by Plan of Correction date 6/19/2022. Licensee Applicant is to provide CCL with updated Fire Clearance once completed.