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25 | Licensing Program Analyst (LPA) Ruth Wallace arrived to the facility approximately 9:00 am to conduct an unannounced Annual Inspection visit to the facility on today's date of 11/10/21. LPA was greeted by Administrator Julie Nonu and staff Apenisa Tora. LPA explained that the purpose of the visit was to conduct an required annual inspection. Currently, there are 6 residents that live in the home. Julie Nonu Administrator Certificate #6038867740 expires 03/03/2022.
LPA evaluated the physical plant to ensure the health and safety of the residents in care. LPA inspected the facility with Administrator including but not limited to the kitchen, resident bedrooms; resident bathrooms, living and dining room, and backyard. The facility had the required carbon monoxide detectors and fire extinguishers expire 7/4/2022 LPA observed the facility to be free of odor, clean and in good repair. There are no bodies of water present in the facility at this time. LPA observed sufficient seven day non-perishable and sufficient two day perishable food supplies. All 6 resident room smoke detectors were tested and all were operable. Hot water registered at 110.3 F.
LPA reviewed 6 resident and 3 staff files, and 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. Medications and Centrally Store Medication Logs were reviewed for residents.
The following documents needed to be submitted to licensing by November 16, 2021:
Administrator Certificate, and a copy of Liability Insurance
LIC 308 Designation of Administrative Responsibility
LIC 500 Personnel Report
LIC 610E Emergency Disaster Plan
Based on today’s visit, Per California Code of Regulations, Title 22 Division 6, Chapter 8, no deficiencies were observed or cited today.
Exit interview conducted. A copy of this report was left with Administrator. |