Facility Evaluation Report

Licensing Program Analyst (LPA) Alviso arrived to conduct a Required- 1 Year inspection, at approximately 12:22pm on 10/24/24, and met with Lead Caregiver Gus Guevarra. There are two other caregivers on duty with Gus. Administrator Janet Hemogenes arrived to the facility to meet with the LPA as Licensee was not available. Tony Guevarra/Licensee has a current Administrator certificate, expires 5/19/2025, he is the primary Administrator.

Currently there are nineteen (19) clients in care at this time. LPA reviewed five (5) client files. All files were complete. LPA reviewed medication records, and medications.

LPA reviewed five (5) staff files. All staff have required criminal record clearance. All staff have first aid and CPR.

LPAs toured the facility with Administrator Janet, and Lead caregiver Gus. Food supply was sufficient. Fire extinguishers, nine (9), were found to be appropriately charged. Residents' common area/TV room was found to be clean and orderly. Cable was working appropriately, and the phone was available and working. Bathrooms were found to clean during the inspection.

LPA discussed with staff to ensure towels and linens are washed and cleaned as needed so clients don't have dirty towels, clothes, and/or sheets. Staff stated their understanding regarding the above. disinfectants/cleaners were locked up and inaccessible to clients. Medications were locked up and inaccessible to clients. Staff stated they will be painting areas throughout the facility as needed, this was discussed during the tour.

Please submit the following required annual updated forms by 11/24/24:

Review Emergency Disaster Plan,LIC610D, if any changes needed, update & submit. If no changes sign and date the review page and submit a copy.