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25 | On August 05, 2024, Licensing Program Analyst (LPA), Venus Mixson arrived at the facility unannounced to conduct Required Annual visit and met with Licensee, Erica Graham-Bullock. LPA Mixson introduced herself and stated purpose of the visit. The facility annual file review was conducted at the Regional Office and additional documents were reviewed on site. The facility is licensed for six ambulatory individuals ages 18-59, with a Developmentally Disabled Adults (DD), population, and is currently serving five Residents.
The facility is a two-story home located at 3656 Ginger St. Perris, CA. 92571. The phone number is (818) 818-1817, and is operable. Following is a summary of todays visit. LPA Mixson observed four bedrooms and three restrooms.
Physical Plant: LPA observed residents’ bedroom, and they were equipped with required furniture as per Title 22. LPA Mixson inspected facility bathrooms, and hot water temperature tested within regulations. The bathrooms were clean, and appliances were operating appropriately currently at the time of this visit. The facility is equipped with operating smoke detectors, carbon monoxide alarms, and fire extinguishers. LPA Mixson observed required postings such as "If you See Something, Say Something" and the "Personal Rights." The cleaning supplies and sharp items were kept locked and inaccessible to the resident in care. There was a designated storage space for the residents' and staff files, and it was locked and inaccessible to resident in care currently at the time of this visit.
Medications: Were locked and inaccessible to resident in care, and there was a sufficient supply of medications. The overall facility is clean, the furniture is in good condition. The facility cooling system and other appliances were operable currently at the time of this visit, and there were safety lights for night throughout the facility.
Food Service: Non-perishable and perishable food supply is sufficient per regulations, and there are a variety of food types available for residents. Dishes and utensils were in sufficient supply and stored properly, and sharp items are locked.
Care & Supervision: Facility has sufficient staff, two staff on site at the time of this visit, and three residents. Licensee informed LPA there are no guns or weapons on site.
Records Review: LPA Mixson reviewed five resident files and one staff file, conducted one staff interview and one resident interview. Previous Community Care Licensing forms were reviewed. There were no Title 22, Division 6 Regulation violations observed or cited during today’s visit.
An exit interview was conducted, and a copy of this report was discussed and given to Licensee, Erica Bullock.
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