Facility Evaluation Report

Licensing Program Analyst (LPA) KaSandra Lopez and Kevin Gaines conducted an unannounced Required 1 Year inspection at the facility today. The LPA initially met with the caregiver and advised them of the reason for today's inspection. There are currently four caregivers and six clients present. Licensee Representative Joemar Ong was contacted and arrived at the facility at approximately 9:03 AM. The facility is vendored by Tri Counties Regional Center as a level 4-I home.

The LPA, along with the Licensee Representative, 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 : 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 stored. Items that could pose a danger were secured in a locked box. During the inspection, the LPA observed the cabinet under the sink with cleaning supplies to be unsecured.

COMMON SPACES: In the common areas, furniture, walls, and flooring were clean and in good condition at the time of the inspection. All indoor and outdoor passages were free of obstruction. The fire extinguisher was fully charged and last serviced on 01/29/2023. At 9:14 AM, the carbon monoxide detector and smoke detectors in the common areas and bedrooms were tested and were operational. Medications and records are centrally stored in a locked cabinet in the living room area. Cleaning supplies were observed to be locked in the garage and inaccessible to clients in care. The backyard has outdoor seating for client use.

BEDROOMS: There are four client bedrooms and one staff bedroom. The LPA observed the client bedrooms to be furnished appropriately with clean linens, appropriate furnishings and sufficient lighting.