Facility Evaluation Report

Licensing Program Analyst (LPA) Emily Peraldi arrived at the facility unannounced to conduct a required annual visit. At 12:50 p.m., the LPA met with staff and explained the reason for the visit. At 2:20 p.m., the Administrator, Baron Graham arrived at the facility. Assistant Administrator, Brigitte Campbell is authorized to sign today’s report. The facility is vendored by Tri-Counties Regional Center as a level 4-I home.

Starting at 1:18 p.m., the LPA, along with staff toured the physical plant areas inside and outside to ensure there are no health and safety hazards.

KITCHEN: The LPA observed the kitchen and dining area. Kitchen appliances are in operable condition. The facility has a sufficient supply of perishable and non-perishable food. At 1:19 p.m., hot water temperature measured at 106.1-degree Fahrenheit. Knives are stored in a locked cabinet behind the kitchen.

BEDROOMS: There are three (3) client bedrooms downstairs and a staff bedroom upstairs. The LPA observed client bedrooms, which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. Inside temperature was maintained at a comfortable level.

RESTROOMS: Client restrooms are relatively clean and sanitary and in operating condition with grab bars and non-skid materials. Starting at 1:27 p.m., hot water temperature measured between 105.9 and 107.0 -degree Fahrenheit. The sinks had sufficient liquid soap, and paper towels.

OUTDOOR SPACE: At 1:29 p.m., the LPA observed the back and side patio which has a covered outdoor area for client use. There are no bodies of water on the premises. Continued on LIC 809-C.