Facility Evaluation Report

At approximately 9:45 AM, Licensing Program Analysts (LPAs) Julie Florio and Star Stevenson arrived unannounced to conduct a required 1-year annual inspection and were greeted by staff. Jenna Baluyot, Administrator was contacted and arrived at approximately 10:15 AM. Facility is an Adult Residential Facility (ARF) with four clients in care. Three clients were present during today's inspection and one (1) was away at an appointment. Facility has a Hospice waiver for two (2) and currently has one client receiving Hospice care. Facility is vendorized with North Bay Regional Center (NBRC).

At approximately 10:30 AM, LPAs initiated a tour of the facility with Administrator and observed the following: Facility is a one story home, was a comfortable temperature, and passageways were free from obstructions. LPAs observed the CCLD reporting poster and personal rights poster hanging in a back hallway of the facility. LPAs advised Administrator to move these posters to a more prominent, common area of the facility where the clients and their guests can view them and to post the facility's visiting hours as well to bring the facility back into compliance with regulation. Administrator agreed. 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 hygiene, paper, and incontinent care products available for clients. Clients' bedrooms were inspected and 3 of 4 rooms were observed missing at least one (1) or more of the required furnishings as outlined in Title 22 regulations. Facility has care plans for these clients which reflect behavioral reasons for the removal of items from their bedrooms as well as an exception for two of the clients. LPA will consult with LPM and follow up with Administrator. 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. Medications were centrally stored and locked. There is a deck and outdoor space for activities in the backyard. Facility has games and crafting supplies available for clients and has their day program send activities to the home for client who is unable to attend and requires constant 2-to-1 supervision. Facility has internet access available to clients in care, and the phone was tested an operational during today's inspection.