Facility Evaluation Report

Licensing Program Analyst (LPA) Delmundo arrived unannounced to conduct health and safety inspection as a result of the Department receiving a complaint (Control # 15-AS-20210901144412). LPA met with Assisted Living Coordinator Vivian Valeros and informed the purpose of visit. Vivian called Associate Executive Director Rosana Frias who arrived after twenty (25) minutes.

LPA started the inspection with Vivian Valeros and Activity Director Ricky Dulay and continued with Rosana Frias. LPA inspected the common areas on the ground floor, kitchen, dining room and patio. LPA randomly selected for inspection 4 resident rooms on the second floor and 4 resident rooms on the third floor.

1. Patio - snail and slugs killer and garden bugs killer spray; uneven pavement by the dining room exit door; pieces of construction metal

2. Second floor - frayed carpet flooring by entrance door in one of the resident's rooms.

3. Third floor - bathroom doors in one of the resident's rooms.

Deficiency is cited from Title 22 California Code of Regulations (see 809D). Failure to submit proof of correction by plan of correction due date and any repeat violations within 12 month period may result in civil penalties.

Deficiencies and plan and proof of corrections were discussed with Rosana Frias.

Exit interview conducted. Appeal Rights, LIC9098 Proof of Correction form and copy of this report provided.