Facility Evaluation Report

On 2/21/23 at 9:45 AM, Licensing Program Analyst (LPA) Malia Thao arrived unannounced to conduct an Annual inspection. LPA explained reason for inspection and was granted entry. LPA met with Licensees (LIC) John and Sylvia Aguilar.

LPA toured inside and outside of facility. No fire clearance issues. Hand sanitizer was readily available to residents and visitors. Social distancing is maintained in the common and dining areas. Bedrooms were checked. Two residents share one room. LPA checked residents’ medications. Cleaning and PPE supplies were checked.

1. LPA observed sharps (knives, scissors, sharp kitchen tools) accessible on kitchen counter and in drawer; bottle of bleach accessible on kitchen floor; multiple cleaner bottles accessible in cabinet under kitchen sink and north hall bathroom; and garden tools (shovels, shears, metal rake, pike axe, cultivator, saw) observed accessible in garage and in back patio.

The following updated forms to be sent to CCL within 2 weeks:

-LIC500, LIC400, LIC402, LIC610D (new revision), LIC9020, LIC308

Deficiencies are being cited based on LPA observations and interviews conducted in accordance with the California Code of Regulations, Title 22, see LIC809D.

Exit interview conducted. A copy of this report and appeal rights was given to Licensee John Aguilar, whose signature confirms receipt of this report.