Facility Evaluation Report

Licensing Program Analyst (LPA) Cuadra arrived unannounced to conduct an Annual Required Inspection and met with House Manager, Jhanell Edmalin. Annual fees are current. Required postings were observed.

LPA/staff initiated a tour of the facility at 1:20 pm and made the following observations: Facility was a comfortable temperature and passageways were free from obstructions. Client rooms are furnished per regulation. Water temperatures in client bathrooms read at 110.6 and 108.1 which are within regulation of 105 and 120 degrees F. At least two days of perishable and one week of non-perishable food was available. Toxins are located in a cabinet in the garage that was not locked during inspection. Medication is centrally stored and locked in a cabinet in the kitchen. Fire extinguishers were last inspected June 16, 2023. Smoke detectors located throughout the facility and the carbon monoxide detector were tested and operational during inspection. Cash resources, medication and medication records were reviewed. Emergency supplies were observed with a first aid kit fully stocked. Most recent disaster drill was conducted September, 2023.

LPA initiated file review at 1:40pm. Four client files and two staff files were reviewed. First Aid certificates for staff are current. Administrator Certificate for Benjamin Cabie, 6026669735, expires on 5/30/25.

Facility to update the following forms and submit to CCL by 3/15/2024: (LIC308) Designation of Administrative Responsibility, (LIC500) Personnel Report, surety bond (LIC610E) Emergency Disaster Plan (if any changes)

Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Appeal rights given. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties.

Exit interview was conducted with House Manager and copy of this report was given.