1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25 | Licensing Program Analyst (LPA) Sarah Hurt conducted an unannounced visit today for the facility’s annual inspection. LPA met with Licensee, Trevor Grant Continual Administrator's Certification expired 12/17/2024. Administration Certification Bureau received application for renewal on 12/16/2024. There are currently 2 residents who reside at this home. LPA inspected the interior and the exterior of the facility including the common living spaces, resident bedrooms and bathrooms, activity rooms, medication storage, kitchen, garage and outdoor areas. Bedrooms were clean and in good repair. There is a locked storage for medications. Food supply is adequate for 2-day perishable and 7-day nonperishable.
Smoke alarms were tested and are operational. The home has a carbon monoxide detector and performs disaster drills as required. Water temperature was tested at 114 degrees. First Aid kit is on site and complete. Toxins and cleaning supplies are locked and inaccessible. LPA reviewed the facility Infection Control Plan (LIC 9282) and Emergency Disaster Plan (LIC610D.) LPA reviewed 2 staff and 2 resident files.
Facility staff 1 is living in a room designated on facility sketch as client room. LPA observed backyard lawn area under construction. LPA observed facility vents, and dressers, and window sills need dusting.
No deficiencies observed or cited during today's inspection per California Code of Regulations, Title 22.
LPA requested the following documents: LIC 500 Personnel Report, LIC 308 Designation of Administrative Responsibility, LIC 610-E the Emergency Disaster Plan and copy of current Administrator’s Certificate to update the facility file. Listed documents shall be sent to Licensing.
Exit interview conducted with Licensee, Trevor Grant , and copy of report left at facility |