Facility Evaluation Report

On 12/17/2024 at 9:00AM, Licensing Program Analysts (LPAs) Patricia Manalo and Luisa Fontanilla arrived unannounced to conduct a Required 1 Year Inspection. DDS Nurse Consultant Kasie Gee arrived with LPAs. LPAs met with Licensing Vocational Nurse, Yang Zhang, who phoned the Administrator and explained the purpose of the visit. Administrator, Remedios Sullera, arrived shortly after. The fire clearance is approved for five (5) all may be bedridden.

LPAs toured the facility inside and out including but not limited to bedrooms, bathrooms, dining area, kitchen, garage, and outdoor area. Smoke and carbon monoxide combination detectors were observed. Smoke detectors are interconnected with sprinklers system. Fire extinguishers were last serviced on 01/22/2024. One week of non-perishable and 2-day perishable food supplies were sufficient. Hot water temperature was measured at 131.3 degrees Fahrenheit in the hallway bathroom. All client bedrooms have automatic hoyer lifts and bathroom lift installed. Medications were locked in a medication cart. First Aid kit is complete. No bodies of water observed. Last fire drill was conducted on 11/20/2024. Emergency Disaster Drill Plan was last posted on 12/17/2024.

Starting at 9:12 AM, LPAs reviewed all five clients files. At 9:49 AM, LPAs reviewed three files and all three have First Aid Certificate. At 11:15 AM, LPAs reviewed client's P & I money with logs. LPAs reviewed a sample of client's medications during inspection.

Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 12/26/2024:

LIC 308 Designation of Administrative Responsibility

LIC 400 Affidavit Regarding Client/Resident Cash Resources