Facility Evaluation Report

At approximately 8:35 AM, Licensing Program Analyst (LPA) Robert Frank arrived unannounced to conduct a Required 1 Year visit. Administrator Mary King arrived at 8:50 AM . Our House is Licensed as a Residential Care Facility for the Elderly (RCFE). The facility is a single story ranch house. The facility has an approved fire clearance for eleven (11) non-ambulatory residents, three (3) of whom may be bedridden. The facility has a Hospice Waiver for six (6) residents. Upon arrival, LPA was informed that there were eleven (11) residents in care. 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 9:00 AM, LPA toured the facility with Administrator King. All exits were clear and unobstructed. The facility's fire extinguishers were last serviced and tagged on 1/14/2026. The Petaluma Fire Department inspected the facility and cleared the fire alarm system in 1/2026. The facility was sufficiently lighted. LPA inspected nine (9) resident bedrooms and found all to have sufficient lighting and furnishings as required per Title 22 Regulations. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. There was an appropriate supply of cleaning products, linens, hygiene products and paper products available for residents. Toxins were observed to be stored inaccessible to residents. The facility has an infection control plan as required. The facility has a required emergency disaster plan. The facility is conducting fire and emergency drills quarterly. The last disaster drill was conducted on 2/16/2026. The facility does have emergency food and supplies to meet the "72 hour shelter in place" requirements. Hot water temperatures for all sinks in facility were found to be within Title 22 regulations of 105 to 120 degrees Fahrenheit. Facility smoke detectors and carbon monoxide detectors are hard wired and were observed to be operational.