Facility Evaluation Report

Mountain View Residence II, Simi Valley09/23/2023Licence 565800010

Capacity6
Census5
Date signed09/23/2023 12:20:07 PM
The inspector’s account

Licensing Program Analyst (LPA) Martha Arroyo arrived at the facility unannounced for a required one-year annual inspection today at 8:00 a.m. The last annual conducted at this facility was on 08/29/2022. Upon arrival, the LPA met with Staff, Elisea Marcelo; the Licensee, Venis Caccam arrived at 8:15 a.m. and at this time, the reason for the visit was explained. The Administrator Kirstie Thompson arrived during the inspection. Entrance interview conducted.

At 8:20 a.m., the LPA along with the Licensee, 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 LPA inspected in the kitchen/food service area at 8:26 a.m. At 8:27 a.m., the hot water temperature was measured in the kitchen at 105.9 degrees Fahrenheit. Kitchen appliances appeared clean and were in operable condition at the time of the visit. The facility has a sufficient supply of perishable and non-perishable food. Additional groceries were delivered at the time of the visit. Food labels were inspected and checked for dates and expiration dates and food labels had expiration date clearly marked. The LPA observed knives and sharps locked under the kitchen sink. Cleaning supplies and disinfectants are kept under the kitchen sink locked and inaccessible to clients in care.

COMMON AREAS: At the time of the visit, living room and dining room furniture was observed to be in good condition. The facility maintained a comfortable temperature. At 8:31 a.m., the smoke detector(s) and carbon monoxide detector were tested and operational at the time of the visit. The fire extinguishers were fully charged and were last serviced 4/27/2023. The LPA observed required postings throughout the common space. There is a functioning telephone on the premises for client use.

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