Facility Evaluation Report

Licensing Program Analyst (LPA) Delmundo arrived unannounced to conduct an annual required inspection. LPA met with Adeliza Magallones, administrator, and informed the purpose of the visit. LPA also met with Celeste Olivarez, facility consultant, and staff, Mary Eileen Olivarez-Legados, Ethel David, Bonifacio Flores and Maria Dolores Floriza.

Facility has Infection Control Plan that was submitted on June 30, 2022.

LPA toured the facility inside out with Adeliza Magallones and Mary Eileen Olivarez-Legados. LPA inspected the kitchen, dining area, living/tv room, common areas, staff and laundry room. bathrooms, side and backyard. LPA randomly selected 5 residents rooms for inspection. Food supplies were observed good for 2 days of perishables and 7 days of non-perishables. Central storage for medications was observed locked.

Facility has 2 in 1 carbon monoxide detector that was tested and observed in operating condition. Hot water temperature in one of the common bathrooms was tested and measured at 119.2 degrees Fahrenheit.

LPA reviewed 5 staff and 5 residents files, and interviewed 3 staff and 3 residents. Medications checked, and compared with records and doctor's orders. Facility does not handle residents' cash resources.

The following updated/current documents were obtained on this same day:

1. LIC308 Designation of Facility Responsibility

2. Proof of $3M liability insurance coverage

Administrator to submit the following updated documents by November 23, 2023 :

2. LIC601E Emergency Disaster Plan (9 pages)