Facility Evaluation Report

Licensing Program Analysts (LPA) Sarah Hurt conducted an unannounced visit today for the facility’s annual inspection. LPA met with facility Facility Administrator, Gloria Waldrum. There are currently 103 clients receiving services at this programs site. LPA inspected the interior and the exterior of the facility including the common spaces, activity rooms, and outdoor areas. Facility appears to be clean and in good repair.

Fire extinguisher is within the safety regulation period. Smoke alarms were tested and are operational. The home has a carbon monoxide detector and performs disaster drills as required. Water temperature was tested at 116 degrees. First Aid kit is on site and complete. Toxins and cleaning supplies are locked and inaccessible.

There were no deficiencies observed or cited during today's inspection per California Code of Regulations, Title 22.

LPA requested the following documents: LIC 500 Personnel Report, LIC 308 Designation of Administrative Responsibility, LIC 610-E the Emergency Disaster Plan and copy of current Administrator’s Certificate to update the facility file. Listed documents shall be sent to Licensing.

Exit interview conducted with Facility Administrator, Gloria Waldrum, and copy of report left at facility