Facility Evaluation Report

Johnson & Johnson Residential Home, Petaluma07/18/2023Licence 496800640

Capacity6
Census4
Date signed07/18/2023 01:53:17 PM
The inspector’s account

Licensing Program Analyst (LPA) Hansen conducted an unannounced Annual Required 1 yr. inspection to this facility and was welcome by Administrator/Licensee Fayretta Johnson. One resident had already left to attend their day program at the time of the visit. There are 4 clients in the facility.

LPA toured the facility on 7/18/2023 at 9:20 AM with administrator/licensee Fayretta Johnson, facility was found to be clean and 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 last charged on 2/2/2023 at the time of the visit. Facility smoke detectors and carbon monoxide were found to be functioning properly at the time of the visit. Hot water temperature measured between 114.6 degrees F and 118.2 degrees F within Title 22 acceptable regulation of 105 to 120 degrees F in 3 of 3 client’s bathroom while touring facility on 7/18/2023 at 9:30 AM. 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 on this day at the time of the visit. Toxins are stored in a locked cabinet inside the facility garage. Garage also now contains a large screen TV with 6 reclying /vibrating chairs. Dangerous items were stored inaccessible to clients. There was a supply of cleaners, hygiene products and paper products available for clients. The bathroom designated for clients at the facility were supplied with individual paper towels; hand soap dispenser was available. All client’s bedrooms have lighting & appropriate furnishings, and beds were outfitted with mattress pads.

A review of four clients and a sample review of two staff records as well as two client’s medications was conducted. LPA reviewed client’s files at 11:00 AM on 7/18/2023 and learned that 4 of 4 clients have an updated reappraisal/needs & care plan and physician’s report.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction