Facility Evaluation Report

Licensing Program Analyst (LPA) Araceli Canela conducted an unannounced Annual Required – 1 yr. inspection. LPA was greeted by House Manager, Mario Gray (MG). The facility currently provides care for 5 clients, and it is licensed for 6 clients, of which 2 may be non-ambulatory.

LPA toured facility and found it at a comfortable temperature with all exits free from obstruction. Client’s bedrooms, common areas, kitchen & food storage areas were inspected. Fire Extinguisher was found to be charged and serviced on 5/22/23. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. Food stored in the kitchen refrigerator were properly stored as per regulations. Toxins are stored in a locked cabinet in the facility kitchen. LPA tested facility smoke alarms and found them to be in working condition. Medications are kept in a secured cabinet located in the kitchen. There was a supply of hygiene products and paper products available for clients. All client’s bedrooms have lighting & appropriate furnishings. LPA found facility staff have proof of 1st Aid & CPR. Water temperature read 107 degrees F. and within the required 105-120 degrees F.

Staff and resident files were in compliance.

Licensee/Administrator to submit updates of the following documents by 6/30/2023.

· LIC 308 Designation of Facility Responsibility

· LIC 400 Affidavit Regarding Client/Resident Cash Resources

· Infection Control Plan of Operation (If changes)