336426503-5-15-2023-18-AS-JARA-CRUTLA-20230515144911

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 336426503
Report Date: 05/15/2023
Date Signed: 05/15/2023 02:49:26 PM

Document Has Been Signed on 05/15/2023 02:49 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME:	PEOPLE'S CARE TRADE WINDS		FACILITY NUMBER:	336426503
ADMINISTRATOR:	BAZILE, FLORENCE		FACILITY TYPE:	735
ADDRESS:	25290 TRADE WINDS DR		TELEPHONE:	(951) 928-8444
CITY:	MENIFEE	STATE: CA	ZIP CODE:	92585
CAPACITY: 4		CENSUS: 4	DATE:	05/15/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Staff, Tasha Foster		TIME COMPLETED:	03:00 PM

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Licensing Program Analyst (LPA) Janira Arreola conducted an unannounced annual required visit on 5/15/2023 at 01:45 p.m. LPA was granted entry and met with Staff, Tarsha Foster, who was informed of the purpose of the visit. At the time of the visit there was (3) staff and (3) clients present.

The facility is a one story home with (4) bedrooms and (2) bathrooms with attached garage. No pools or firearms are being kept at the facility. The clients served are adults between the ages of 18-59. The facility is approved for delayed egress and locked food per their program plan. LPA conducted a tour of the interior and exterior, reviewed facility documents and conducted a staff and client interviews. LPA observed the following:

Infection Control: The LPA observed the hand washing stations in the facility restrooms and kitchen had hand hygiene supplies and hand washing signs. LPA observed PPE equipment and cleaning supplies to do regular cleaning of the facility. LPA reviewed the facility's infection control plan which met department requirements. LPA reviewed staff records and found that all staff had infection control training.

Physical Plant: LPA observed the client bedrooms. Physical plant, floors, windows, and doors were observed to be clean. Fixtures and furniture were in good repair were present. The outdoor area was observed to be free of hazards. LPA observed outdoor furniture and shaded area for clients. Laundry equipment was observed to be in good working condition. The sharp and dangerous objects were observed to be locked and inaccessible to clients in locked facility kitchen. The smoke detector and carbon monoxide was operational, and the hot water temperature 108F.

Food Service: LPA observed facility kitchen had the ability to prepare food in clean environment and possessed equipment in good working condition. LPA observed the facility met the required 2-day supply of perishable and 7-day supply of non-perishable foods.

Care & Supervision/Administration: Adequate staff are present for the supervision of clients during the visit. LPA also reviewed the staff scheduled showing adequate staff coverage. Facility sketch, exit routes, personal rights, complaint information and emergency phone numbers were found posted in the facility. The listed administrator, possesses a current administrator's certificate.

SUPERVISORS NAME: Joel Esquivel
LICENSING EVALUATOR NAME: Janira Arreola
LICENSING EVALUATOR SIGNATURE:	DATE: 05/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2023

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
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: PEOPLE'S CARE TRADE WINDS	FACILITY NUMBER: 336426503
	VISIT DATE: 05/15/2023

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Record Review and Resident/Staff Files: LPA reviewed (2) staff files and training. All staff have criminal clearance and updated training along with CPR/First Aid Certification. Two (2) client files were reviewed, and possessed all required paperwork.

Health Related Services/ Incidental Medical Services: All client medication was locked in closet. LPA reviewed client medications for (2) client and found all medication listed on MARS and all required labeling was found to be in place.

Disaster preparedness: LPA reviewed the facility's emergency and disaster plan which met the department standards. LPA reviewed documentation showing the facility's last fire and earthquake drills conducted on 4/22/2023 which met the department requirements. LPA observed all facility exits were clear from obstructions. LPA observed emergency supplies in the garage.

No deficiencies were cited at the time of the visit.

An exit interview was conducted where a copy of this report was provided to the Staff, Tarsha Foster.

SUPERVISORS NAME: Joel Esquivel
LICENSING EVALUATOR NAME: Janira Arreola
LICENSING EVALUATOR SIGNATURE:	DATE: 05/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2023

LIC809 (FAS) - (06/04)

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