Facility Evaluation Report

Licensing Program Analyst (LPA) Karina Canela conducted a Pre-licensing inspection on 02/13/2023. LPA met with Elizabeth Hall , who will be the Administrator when the facility is approved for licensure. Staff Kasey, Julia, and Travis were also present. The facility has a fire clearance approval from the City of Fairfield Fire Department for a total capacity of 32 ambulatory. The facility does not have approval from the City of Fairfield Fire Department to accept or retain non-ambulatory and/or bedridden clients. Facility will operate with a 24/7 staffing and Licensee will ensure sufficient staffing at all times to meet the needs of clients and day staff-client ratio of no less than one direct care staff to three such clients per regulation 85065.5 (a)(2) and night supervision per regulation 85065.6 (d) . The applicant has not submitted any waivers at this time. The facility does not have approval to secure/lock the perimeter, if applicant wishes to do so they understand they must submit a waiver to Community Care Licensing and obtain approval from the Fire Department.

During today’s visit LPA observed the following items:

· Lockable separate cabinets for medications, toxins, and knives.

· Building smoke detectors, which are interconnected, were tested & observed to be operational

· 16 Carbon monoxide detectors installed in each client bedroom unit (8 in building 2271; 8 in building 2251)

· Complete first aid kit, bathroom night-lights, and flashlights for emergency lighting

· Paper products and hygiene supplies available

· 7 Fire extinguishers charged and serviced 06/13/2022

· Required furnishings (bedframe, mattress, chair, nightstand, lighting, drawer space) in 16 of 16 resident bedrooms

· Administrator Certifications; required postings (Personal Rights, Emergency plan/numbers, sample weekly activity schedule, sample menu, and visitor policy). Report continued on LIC809-C...