Facility Evaluation Report

Licensing Program Analyst (LPA) Renee Campbell arrived to the facility unannounced to conduct an annual inspection at approximately 10:00 am. LPA Campbell met with Valeria Orozco, Administrator and explained the purpose of the visit. The administrator's certificate # 6064194735 and will expire on 09/21/2024. The current census is 46 residents with 20 staff.

The facility is a one floor building licensed to service mentally disabled adults ages 18 to 59. No body of water was found. Eight of the clients may be non-ambulatory. Davis Guest Home #1 is divided by gender with a male and female wing. Upon entry, LPA Campbell observed residents getting snacks, socializing or sitting quietly at dining room tables. A receptionist was sitting at the entry of each building.

LPA Campbell inspected the physical plant including but not limited to the common area, kitchen, dining area, client bedrooms, client bathrooms, laundry room and outside courtyards of the facility to ensure compliance with Title 22 regulations. The facility was observed to be free of odor and in good repair. LPA Campbell observed that four residents shared a bathroom in a suite of rooms. Hot water temperature was measured in resident bathroom at 107 degrees Fahrenheit which is within the required maximum range of 105 degrees F (40.5 degrees C) and not more than 120 degrees F (48.8 degrees C) While there were tubs in the suites, the knobs and faucets were removed and residents in each wing shared a shower. The shared shower is accessed from the hall and is used by 16 women on one wing and the two showers on the men's side in the other wing is used by 28 men. LPA Campbell observed a non-slip pad on the shower floor and grab bars on the walls. There were no changes to the building layout since the most recent floor plan.

The administrator toured the long term pantry with LPA Campbell. The pantry shared the building with a freezer and refrigerator, washer and dryer and was attached to a maintenance section with tools and cleaning supplies. Food items such as cereal, canned vegetables and fruit and powdered pudding were observed by LPA Campbell. The powdered pudding was observed to not have an expiration date. The temperatures for the freezer and the refrigerator were in compliance. There was enough perishable food within the facility to last 2 days. There was enough non-perishable food to last 7 days as well.

A gas range, refrigerator and fresh fruits and vegetables were observed by LPA Campbell and the administrator in the kitchen as well as a monthly menu. Sharps were kept inaccessible from residents in a locked drawer and the kitchen was locked when staff were not present. The smoke / carbon monoxide alarm was tested successfully for the facility. Bedrooms had twin beds, linens, night tables, chairs and closets.

The thermostat was set at 73 degrees Fahrenheit which was between the required minimum of 68 degrees F (20 degrees C) and a maximum of 85 degrees F (30 degrees C). Fire extinguishers were most recently inspected on 08/08/2023. No deficiencies cited.

The following forms and documents were requested to be updated and submitted into CCL for review by this LPA:

LIC 308 Designation of Facility Responsibility

LIC 400 Affadavit regarding resident cash

There were no deficiencies observed or cited during this annual visit at this time.