331800437-9-19-2023-18-AS-JROO-CVTP8L-20230919110542

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 331800437
Report Date: 09/19/2023
Date Signed: 09/19/2023 11:06:06 AM

Document Has Been Signed on 09/19/2023 11:06 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE AC/SC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME:	LOAFER'S LANDING ADULT RESIDENTIAL FACILITY		FACILITY NUMBER:	331800437
ADMINISTRATOR:	ALOAF WALKER		FACILITY TYPE:	735
ADDRESS:	5656 CHERYL STREET		TELEPHONE:	(951) 357-2244
CITY:	HEMET	STATE: CA	ZIP CODE:	92544
CAPACITY:	4	CENSUS: 3	DATE:	09/19/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Administrator Aloaf Walker		TIME COMPLETED:	11:15 AM

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On 9/19/2023, Licensing Program Analyst (LPA) Janette Romero arrived unannounced at the facility to conduct an annual required visit. LPA was greeted and granted entry by Administrator Aloaf Walker who was informed of the purpose of visit. During the visit, there was (2) staff present and LPA was informed that three (3) clients were at day program.

The facility is approved to care for four (4) ambulatory clients and serves adults ages 18-59. LPA toured the facility's interior and exterior with Administrator Walker. The facility is made up of a one-story home with four (4) client bedrooms, one (1) client bathroom, two (2) living rooms, a staff room, staff bathroom, kitchen, dining room, and garage. During the visit, LPA observed the following:

Kitchen: Kitchen area to be clean and food is stored in a safe and healthful manner. The facility had a 2-day supply of perishable food items and 7-day of non-perishable food items. Knives were secured in a kitchen cabinet.

Dining and Living rooms: LPA toured the dining and living rooms. LPA observed areas to be clean and furniture in good condition. LPA observed a play station and X-box game console in the living room available for client use.

Hallway: LPA toured the hallway and observed hallway to be clean with no pathway obstruction. Carbon monoxide and smoke detectors were tested and functioning properly. Two (2) fire extinguishers were charged and mounted throughout the facility.

Continued on LIC809-C..

SUPERVISOR'S NAME: Joel Esquivel	TELEPHONE: (951) 248-0312
LICENSING EVALUATOR NAME: Janette Romero	TELEPHONE: (951) 248-0350
LICENSING EVALUATOR SIGNATURE:	DATE: 09/15/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE AC/SC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: LOAFER'S LANDING ADULT RESIDENTIAL FACILITY	FACILITY NUMBER: 331800437
	VISIT DATE: 09/19/2023

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Continued from LIC809
Centrally Stored Medications: LPA observed three (3) first aid kits with required components. Medications were secured in a file cabinet in the staff room. LPA reviewed physical medications for two (2) clients as well as the Medication Administration Record (MAR) used to log administration of clients’ medications. No discrepancies discovered.

Bedrooms: Client bedrooms were each furnished with a bed, chair, closet, clothing storage and lighting. Home temperature was set at 72-degrees Fahrenheit.

Bathrooms: Bathrooms have a working toilet, wash basin, and were equipped with a nonskid mats in the shower. The hot water temperature in the bathroom measured at 114-degrees Fahrenheit. The facility has clean towels, blankets and linen are available in different colors for the clients in care.

Laundry/Garage: LPA observed the laundry room and garage to be clean. Washing machine and dryer are in good repair. Cleaning solutions and chemicals are secured in a locked hallway cabinet. The facility had four (4) backpacks filled with emergency kits available for client use.

Records: Staff present have a criminal record clearance on file, are associated to the facility and have current CPR/First Aid certification.

Yard/Outside Area: Covered patio seating is available for clients in care. A wood wall secured the entire backyard. All outdoor pathways were free of obstructions. No bodies of water were observed.

Clients' Cash Resources: LPA reviewed the Record of Client's/Resident's Safeguarded Cash Resources (LIC 405) used to record clients' cash resources. No discrepancies discovered.

During today's visit, LPA did not observe any deficiencies. An exit interview was conducted, and a copy of this report was reviewed and provided to Administrator Walker.

SUPERVISOR'S NAME: Joel Esquivel	TELEPHONE: (951) 248-0312
LICENSING EVALUATOR NAME: Janette Romero	TELEPHONE: (951) 248-0350
LICENSING EVALUATOR SIGNATURE:	DATE: 09/19/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2023

LIC809 (FAS) - (06/04)

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