Facility Evaluation Report

At approximately 12:40 PM, Licensing Program Analyst (LPA) Magdaleno arrived unannounced to conduct a required 1-year annual inspection and was greeted by Administrator Shaheed Evans. Facility is an Adult Residential Facility (ARF) with five (5) clients in care. Three (3) clients were away at day program and two (2) clients were present during inspection. Facility is serviced by vendor North Bay Regional Center (NBRC).

At approximately 1:00 PM, LPA initiated a tour of the facility with Administrator and observed the following: Facility is a two (2) story home, was a comfortable temperature, and passageways were free from obstructions. Facility's fire extinguisher was observed charged and last serviced 7/25. Smoke and Carbon Monoxide detectors were tested and operational during inspection. Water temperatures in client bathrooms read at 117.1 degrees F and 116.7 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. Cabinets containing cleaning supplies and other items that could pose a risk were locked. 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. LPA observed three (3) locked sheds in the backyard which were inspected and observed to contain client belongings and overflow storage. Medication is centrally stored and locked. Administrator Certificate for Shaheed Evans certificate number 6012483735 expires 10/27. Facility conducts quarterly disaster drills, and the most recent drill was conducted 8/25. LPA observed facility's infection control plan and emergency disaster plan. LPA observed a supply of PPE, emergency supplies, a first aid kit, and flashlights.