Facility Evaluation Report

On this day, April 11, 2024, at 1:15 p.m., Licensing Program Analyst (LPA) Delmundo arrived unannounced to conduct an annual required inspection. LPA met with Laura Carter, administrator, and informed the reason for visit. LPA also met with staff, Zenaida Siwa and House Manager Hilario 'Larry' Siwa.

Administrator submitted copy of LIC9282 Infection Control Plan which LPA received on July 21, 2023.

LPA toured the facility inside and out with the administrator. The facility comprises of a 2 level building, a detached cottage and detached storage/office. LPA inspected the bedrooms, bathrooms, kitchen, dining and living rooms, detached storage/office and residents' room in detached cottage. Food supplies were observed good for 2 days of perishables and 7 days of non-perishables. Central storage for medications was observed locked.

Fire extinguishers were observed fully charge with tags showed serviced November 15, 2023. Facility has carbon monoxide and smoke detectors that were tested and observed functional. Hot water temperature in one of the common bathrooms was tested and measured at 106.7 degrees Fahrenheit. Facility conducts fire drill monthly and earthquake drill every quarter, and records showed last conducted March 29, 2024 and January 21, 2024 respectively.

LPA reviewed 5 residents and 4 staff files, and interviewed 3 residents and 2 staff. Medications were checked and compared with doctor's order and LIC622 Centrally Stored Medication and Destruction Records. Residents' P&I were checked and compared with the last recorded balance.