Facility Evaluation Report

8/12/2025 Licensing Program Analyst (LPA) Hansen conducted an unannounced Annual Required 1 yr. inspection to this facility and was welcome by Administrator/Licensee Fayretta Johnson. Facility is a residential care home for the elderly, which is a care home for Regional Center clients. This single story building with 3 resident bedrooms has fire clearance for six (6)= four (4) Non-ambulatory & two (2) Ambulatory, with a Hospice waiver for two (2). One resident had left to attend their day program at the time of the visit. There are 4 clients in the facility.

LPA toured the facility on 8/12/2025 at 12:10 PM with licensee/administrator 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 inspected on 4/4/2025 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 109 degrees F and 110.4 degrees F within Title 22 acceptable regulation of 105 to 120 degrees F in 3 of 3 client’s bathroom while touring facility on 8/12/2025. 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. 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. Bathrooms were equipped with necessary grab bars, and slip-resistant mats, strips, or flooring in all bathtub and shower floors as required by Title 22 regulations All client’s bedrooms have lighting & appropriate furnishings, and beds were outfitted with mattress pads.