Senior Care Records.

Facility Evaluation Report

Hazel Home, Santa Rosa05/13/2025Licence 496803290

Capacity6
Census5
Date signed05/13/2025 03:19:39 PM
Name of licensing program analystShannan Hansen
Name of licensing program managerBethany Moellers
The inspector’s account

Licensing Program Analyst (LPA), Shannan Hansen arrived unannounced to conduct an Annual inspection of facility. LPA met with Debbie Miller, Licensee/Administrator and Robert "Tony" Miller, designee. There are 5 clients that reside at facility, some were either leaving for programs or were already out in the community at time of visit.

At approximately 8:25 AM LPA toured the facility with Administrator, Debbie Miller. Building and grounds were found to be clean and in good repair. LPA observed all walkways and exits to be unobstructed. The amount of fresh and non-perishable foods was within regulations. Hot water temperature of faucets accessible to clients registered within regulations of 105 degrees F and 120 degrees F. Medications were centrally stored and inaccessible to clients in care. Medication and Medication record review was completed. Toxins are locked in garage and downstairs laundry room inaccessible to clients. Emergency supplies are also kept in the garage. Laundry room contains enough linens for clients in care. New wired smoke alarm system was functional and carbon Monoxide detectors were present and tested, in working order. Fire extinguisher was last inspected 12/10/2024. Required postings were observed. Sufficient lighting was present in common areas, hallways, and client rooms. Required furniture was also present in client rooms. Disaster Drills are conducted quarterly, with the last drill conducted 03/07/2025.

At approximately 9:00 AM, LPA reviewed 5 of 5 Client files and 4 of 4 staff files, which were all found to be well organized, thorough and contained the required documentation. Staff have required First Aid certificates and Criminal Record Clearance. P&I monies were documented, secured and not commingled. Administrator Certificate for Debbie Miller # 7035344735 expires 2/3/2026.

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