Senior Care Records.

Facility Evaluation Report

Ibarra Family Home #2, Simi Valley12/07/2023Licence 565801459

Capacity6
Census5
Date signed12/07/2023 02:07:36 PM
The inspector’s account

Licensing Program Analyst (LPA) Martha Arroyo arrived at the facility unannounced to conduct a one year required annual at 9:00 a.m. The last annual conducted at this facility was on 11/22/2022. Upon arrival, the LPA knocked on the front door and rang the doorbell, but there was no answer. There were no staff or residents present. The LPA called the facility at 9:05 a.m. with no answer. At 9:15 a.m., the LPA called the Administrator, Karla Valdez, and at this time, the reason for the visit was explained. The Administrator arrived at the facility at 9:35 a.m. Entrance interview conducted.

At 9:37 a.m., the LPA along with the Administrator 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.

Kitchen: The kitchen/food area was observed at 9:43 a.m. The hot water temperature was measured at 113.2 degrees Fahrenheit at 9:45 a.m. The facility has a sufficient supply of non-perishable and perishable food items. Food labels were inspected and checked for dates and expiration dates and food labels had expiration date clearly marked. At 9:44 a.m., the LPA observed a butter knife on the kitchen counter. The Administrator locked item immediately. The knives and sharps are kept in a locked drawer.

Living Room / Dining Room : Living room and dining room furniture was observed to be in good condition, and the lighting was adequate. The facility maintained a comfortable temperature. At 9:49 a.m., the smoke detector(s) and carbon monoxide detector were tested and were operational. The fire extinguisher was observed to be fully charged on . There is a functioning telephone on the premises.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction