Senior Care Records.

Facility Evaluation Report

Nodot Home, Simi Valley12/10/2022Licence 565801338

Capacity6
Census5
Date signed12/10/2022 12:00:47 PM
The inspector’s account

Licensing Program Analyst (LPA) Emily Peraldi conducted an unannounced required annual visit. At 9:58 a.m., the LPA met with staff and explained the reason for the visit. At 10:44 a.m., the Administrator arrived at the facility. The Administrator authorized staff, Abiodun Adedigba to sign the report. This annual had a specific emphasis on infection control practices and procedures. When the LPA arrived, there was three staff and five clients present.

At 10:20 a.m., the LPA, along with staff toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that the facility is in compliance with Title 22 Regulations.

KITCHEN: The LPA observed the kitchen/dining area. Knives and cleaning supplies are stored in a locked storage closet. Kitchen appliances are in operable condition. The facility has a sufficient supply of perishable and non-perishable food. At 10:23 a.m., hot water measured at 105.1-degree Fahrenheit.

COMMON SPACES: All indoor and outdoor passages were free of obstruction. At the time of the visit, living room and dining room furniture was observed to be in good condition. The LPA observed the fire extinguisher to be fully charged and last serviced on 08/24/2022. Signs are posted throughout facility to promote handwashing, and cough/sneeze etiquette. At 10:29 a.m., fire alarms and carbon monoxide detectors were tested and functioning properly. Medications are centrally stored and in a locked filing cabinet near the living room.

BEDROOMS: There are four client bedrooms. The LPA observed the client bedrooms, which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting.

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