Facility Evaluation Report

Licensing Program Analyst (LPA) KaSandra Lopez conducted an unannounced Required 1 Year inspection at the facility today. The LPA met with caregiver Keith Smith and informed him of the reason for today's visit. When the LPA arrived there was one caregiver and four clients present. Administrator Baron Graham was contacted and informed of the inspection. Graham was unable to come to the facility for the inspection, but assisted Administrator Brigitte Campbell came to the facility during the inspection.

This annual had a specific emphasis on infection control practices and procedures. The facility is vendored by Tri-Counties Regional Center as a level 4-I home. The LPA and caregiver toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. The following was observed:

KITCHEN : At 12:03 PM, the kitchen and food storage areas were observed. Kitchen appliances appeared to be in operable condition. The facility has a sufficient supply of perishable and non-perishable food and emergency water in the garage.

COMMON SPACES: All indoor and outdoor passages were free of obstruction. At the time of the visit, living room and dining room furniture was observed to be in good condition. The fire extinguisher is fully charged and last serviced on 02/22/2022. At 12:43 PM, the carbon monoxide detector and smoke detectors in the home and bedrooms were tested and were operational. Medications are locked and centrally stored in a locked closet in the staff room/office. There is outdoor seating for client use. Cleaning supplies are stored in the locked garage.

BEDROOMS: There are three client bedrooms downstairs and a staff bedroom upstairs. The LPA observed the client bedrooms, which were furnished appropriately with clean linens, appropriate furnishings, and sufficient lighting. Report continued on LIC 809-C.