Facility Evaluation Report

This is an amended report to rescind the civil penalty issued from Civil Penalty Assessment-Immiediate $500 and Repeat violations LIC421IM on 7/21/2023 and issue the correct Civil Penalty Assessment- Caregiver background check LIC421BG $500 civil penalty.

At 08:15 a.m. Licensing Program Analysts (LPA) Esther Cortez arrived at the facility unannounced to conduct a required annual visit. When the LPA arrived, there were one (1) staff and two (2) clients present. The clients left to day program shortly after the LPA arrived. The LPA was greeted by staff and informed them of the reason for the visit. Co-Administrator Lailani Macasias arrived shortly after

At 08:35 a.m., the LPA conducted a tour of the physical plant with administrator Lailani to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. The following was noted: Facility is a single-story residence that consists of three (3) resident bedrooms, one (1) office, one (1) medication room, and two (2) bathrooms. The home is vendored by Tri-Counties Regional Center as a level 4-G home. The LPA observed three (3) fire extinguishers at the facility, which were fully charged and last serviced 01/13/2023. At 09:10 a.m., all smoke alarms and carbon monoxide detectors were tested. The smoke detector in the living room was observed to not be working. Upon observation the administrator had staff installed a new smoke detector during the visit. LPA observed all required postings.

Kitchen: During the facility tour at 08:40 a.m., the kitchen appeared clean and the appliances and fixtures functional. The LPA observed a sufficient supply of perishable and non-perishable food at the facility; Sharp objects are stored in a locked box and cleaning supplies are stored in locked cabinets. Food is prepared based on the menu and modified as needed for individual clients. Snacks and beverages are always available for clients. Bedrooms: The LPA observed all resident bedrooms properly furnished with at least one chair, night-stand and sufficient lighting for each resident. The bedrooms had appropriate and adequate bedding and linens such as sheets, pillowcases, mattress pads, and blankets. Report will continue on 809-C.