Facility Evaluation Report

Licensing Program Analyst (LPA) Valeria Conway arrived at the facility unannounced to conduct a required Annual visit at 09:15 a.m. At the time of arrival, no one was in the home. The LPA contacted Administrator, Kenneth Carpenter via phone. Administrator was unavailable during today’s visit, but authorized Direct Care Staff, Arthur Harris to be present and sign today’s report. At 9:51 a.m. the LPA met with Direct Care Staff, Arthur Harris and explained the reason for the visit.

At 10:05 a.m., the LPA toured the physical plant areas inside and outside, with Direct Care Staff to ensure there are no health and safety hazard and facility is in compliance with Title 22 Regulations. The following was noted: Facility is a single-story residence that consists of four (4) client bedrooms and two (2) bathrooms. T his facility doesn’t have a staff room, facility provides 24/7 care. The facility is vendored through Tri-Counties Regional Center as a level 4i home. The Facility does handle cash resources for all clients. Surety Bond is current.

BEDROOMS: LPA observed four single-occupancy resident bedrooms which were furnished with clean linens, appropriate furnishings, and sufficient lighting.

RESTROOMS : There are two resident restrooms which were observed clean, sanitary, and in operating condition with grab bars and non-skid surfaces at the time of visit. The LPA observed sufficient amounts of soap, and paper products. Hand-washing signs were observed at the time of the visit. Restroom one (1) hot water measured 107.6 Fahrenheit at 10:14 a.m. Restroom two (2) hot water measured 112.5 Fahrenheit at 10:17 a.m.