Facility Evaluation Report

Licensing Program Analyst (LPA) KaSandra Lopez conducted an unannounced Required - 1 Year inspection at the facility today. The LPA met with staff Ethel Tayag and explained the reason for the inspection. Administrator Susie Mix was unable to come to the facility today but the LPA spoke with her on the phone and she gave permission for staff to sign the report.

This annual had a specific emphasis on infection control practices and procedures. The LPA 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:

The carbon monoxide and smoke alarms were tested and all functioned properly. The fire extinguisher was fully charged and last purchased on 03/13/2022.

KITCHEN: Knives are stored in locked cabinets. Kitchen appliances were in operable condition. The facility has a sufficient supply of perishable and non-perishable food stored in the kitchen and the garage. Medications are stored in a locked medicine cabinet in the dining room.

BEDROOMS: The LPA observed six client bedrooms which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting.

RESTROOMS: There is one common restrooms and two private restrooms for client use. The restrooms were clean and sanitary with hand soap and paper towels. At 2:26 PM the hot water temperature tested in the common restroom measured at 100 degrees F. An advisory notice was issued.

COMMON SPACES: Living room and dining room furniture was observed to be in good condition. Required signs were posted. Cleaning supplies were observed to be locked in the garage and inaccessible to clients in care. The backyard has covered seating for client use.