Facility Evaluation Report

At approximately 9:15 AM, Licensing Program Analyst (LPA) Magdaleno arrived unannounced to conduct a required 1-year annual inspection and met with Administrator Angelita Mamsaang. Facility is an Adult Residential Facility (ARF) with three (3) clients in care. LPA was informed that all clients were away at Day Program during this visit. Facility is serviced by vendor North Bay Regional Center (NBRC). LPA reviewed the Facility's Staff Roster and found that all staff on-site were background cleared and associated to the facility per regulation.

At approximately 10:15 AM, LPA initiated a tour of the facility with Administrator and observed the following: Facility is a one (1) story home, was a comfortable temperature, and passageways were free from obstructions. Facility's fire extinguishers were observed charged and last serviced 4/25. Smoke and Carbon Monoxide detectors were tested and operational during inspection. Water temperatures in client bathrooms read between 119.3- and 106.7 degrees F which is within the allowable range of 105 to 120 degrees F per Title 22 regulations. LPA observed a supply of clean linens, hygiene, and paper products available for clients. Clients' bedrooms were inspected and observed to have all the appropriate furnishings as outlined in Title 22 regulation.

LPA observed accessible cleaning supplies, review of client records indicated they are not at risk and are in charge of chores such as cleaning and laundry as per their care plans. Facility has at least two (2) days of perishable food and seven (7) days of non-perishable foods, as well as an emergency water supply. Facility has an internet access devise and internet available to clients in care, and the phone was tested and operational during today's inspection.