Facility Evaluation Report

Licensing Program Analyst (LPA) Jill Nakagawa arrived unannounced to conduct a Required 1-year annual inspection and was greeted by Licensee, Ocie Richard. At the time of inspection there was one staff providing care and supervision to three clients, the other client was out of the facility on a trip.

LPA and Ocie Richard toured the facility and made the following observations: The facility was clean and a comfortable temperature. Signs were posted at the entry reminding visitors of Infection Control Precautions. Bathrooms were equipped with non-slip mats and grab bars. All residents their own hand washing supplies.

Facility has an activity room and residents are supervised while partaking in developed activities. Facility organizes transportation for medical services and activities. Bedrooms were furnished as required per regulation. Outdoor pool is covered and secured with required fencing.

LPA reviewed 3 staff records and 3 resident records. LPA and Ocie Richard observed that the facility has completed construction on an existing outbuilding, which will now be a second residence for staff. LPA advised that they submit copies of permits, facility sketch and facility plan, after final approval by PG & E.

Exit interview conducted with Ocie Richard.