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25 | Licensing Program Analyst (LPA) Ruth Wallace conducted an unannounced annual inspection. LPA met with administrator and explained the purpose of the visit. Administrator certificate # is 6051257740 expires on 02/20/2025.
LPA inspected the physical plant including but not limited to the common area, kitchen, dining area, client bedrooms, client bathrooms, laundry room and outside courtyards of the facility to ensure compliance with Title 22 regulations. This facility is a single story building licensed to serve six (6) non-ambulatory clients. LPA observed the facility to be free of odor, clean and in good repair. LPA observed bedrooms to be properly furnished with appropriate bedding and lighting. There are no bodies of water present.
LPA observed sufficient seven day non-perishable and two day perishable food supplies. Hot water temperature was measured at 113.2 degrees Fahrenheit in resident bathroom sink, which is within the required regulation of 105 to 120 degrees Fahrenheit. Fire extinguishers, smoke and carbon monoxide detectors are in compliance with fire safety. Fire extinguisher last serviced 10/16/2023. Fire Drill last conducted 4/1/2024. LPA checked medication storage and found medication to be locked away and inaccessible to clients. First aid kit was checked and is complete.
LPA reviewed three resident files and three staff files, including criminal record clearances. A review of staff records indicates that all facility staff or other individuals who require caregiver background checks are Fingerprint cleared and associated to the facility. LPA verified staff training for staff file reviews.
LPA requested the following updated documents for community care licensing to be submitted via email by May 23, 2024: LIC 308 Designation of Administrator, LIC 500 - Personnel Report, Copy of Administrator's Certificate, and Copy of Liability Insurance with expiration date. ruth.wallace@dss.ca.gov
Based on today’s visit, Per California Code of Regulations, Title 22 Division 6, Chapter 8, no deficiencies observed or cited today.
Exit interview conducted with administrator. A copy of report and LIC 811 (Confidential Names) left at facility. |