Facility Evaluation Report

Licensing Program Analyst (LPA) Stevenson arrived unannounced to continue a required annual inspection at approximately 1:45 PM and met with caregiver Annie Marjorie Vinluan.

Four staff were present and found to be background cleared and associated to the house through Guardian.

At approximately 2:30PM record review began

Five (5) staff files were reviewed and it was observed that four (4) of five (5) staff files did not have evidence of 20 hours annual training, eight hours of which shall be dementia care training, as required by subdivision (a) of Section 1569.626, and four hours of which shall be specific to postural supports, restricted health conditions, and hospice care, as required by subdivision (a) of Section 1569.696 (Technical Deficiency issued)

Five (5) client files were reviewed and five of (5) client files were found to have all required documentation.

Medicines were found to be centrally stored and locked.

Last disaster Drill was conducted January 8th. 2025

Deficiencies cited from Title 22 Regulations and/or the California Health and Safety Code.

Updated Certificate of Liability Insurance was obtained

Licensee is asked to submit a copy of her updated lease agreement.

An exit interview was conducted, and Plans of Corrections were reviewed and developed collaboratively. A

copy of this report, LIC 809-D, and Appeal Rights were discussed and provided