Senior Care Records.

Facility Evaluation Report

Mountain View Residence, Simi Valley02/10/2022Licence 561703268

Capacity6
Census3
Date signed02/10/2022 11:35:49 AM
The inspector’s account

Licensing Program Analyst (LPA) Brian Balisi arrived at the facility unannounced to conduct a required annual. This annual had a specific emphasis on infection control practices and procedures. Upon arrival LPA met with Administrator Adele Anderson and explained the reason for the visit.

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 carbon monoxide and smoke alarms were tested and all functioned properly. The fire extinguisher was fully charged and last serviced March of 2021.

Kitchen: The kitchen appeared clean and the appliances and fixtures functional. LPA found a sufficient amount of perishable food stored in the fridge and non-perishable food properly stored in a pantry on the exterior of the kitchen. Knives and sharps are stored in a locked cabinet under the sink.

Bedrooms: There were (7) bedrooms total with (1) bedroom designated for staff use. LPA observed staff room to be locked and empty at this time. All bedrooms for clients use were properly furnished and had appropriate bedding and linens.

Bathrooms: There were two bathrooms designated for clients' use. Both bathrooms were clean, properly supplied and had functional fixtures. Hot water temperature was measured between 105.6 - 106.1 degrees Fahrenheit.

Common Areas : These included the living rooms and dining areas. The common areas were properly furnished. Properly labeled medications were observed to be locked in a cabinet in the dining area next to the sliding door. LPA observed multiple board games and activities on the shelves in the living area.

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