Facility Evaluation Report

Licensing Program Analysts (LPA) Katrina Walters conducted a pre-licensing inspection on 06/14/2022. LPA met with Applicant, Robert Christian Bayot who will be Administrator when the facility is approved for licensure. On 3/14/22 The facility was granted a fire clearance approval from the Vacaville Fire Department for a capacity of 5 non-ambulatory residents. Facility will operate with a live-in caregiver and Licensee will ensure sufficient staffing at all times. The facility is one level with 3 bedrooms that may be used for residents, Staff room, 2 bathrooms, living room, dining room, kitchen, medication cabinet, laundry room with storage room and Garage. The applicant has a dementia care plan that has been approved.

During today’s visit LPA observed the following: The facility was clean and comfortable temperature. Upon entry there was an area in which staff will check in visitors. Hand sanitizer, a temperature gun, pulse oximeter, and additional Personal Protective Equipment were available for visitors and staff. LPA observed the following signs posted in the entry way: Residents right's to counsel, Let Us Know complaint poster, hand washing, masks required, personal rights, emergency disaster drills, staff roster, activity poster and menu. The Applicant has ordered the Ombudsman poster and will receive the poster after licensure.

LPA toured the facility with applicant and observed that all resident's rooms were furnished as required by regulation. A location has been designated for medication and sharps to be locked, and stored. Auditory alarms were on. Bathrooms were equipped with paper towels and hand soap. Grab bars and slip mats were present for residents safety. There were a supply of linens, paper products, and hygiene supplies available. Kitchen was spacious and clean, adequate supply of dishes and utensils. The refrigerator was clean, with perishable and non-perishable foods. The facility has a phone line designated for residents use.