Facility Evaluation Report

On this day at around 9:50 am, Licensing Program Analyst (LPA) Luisa Fontanilla arrived unannounced to conduct annual required inspection and met with Administrator Jean Holt. LPA explained to Holt and purpose of the visit.

During the visit, LPA inspected the facility inside and out including but not limited to resident bedrooms, bathrooms, kitchen, dining area, garage and backyard. Hot water measured at 110 degrees Fahrenheit. There was sufficient supply of perishable and non perishable foods. Medicines were observed locked in a cabinet. Fire extinguisher was observed full with purchase date of 4/17/2023. There were sufficient hygiene products observed. Ample amount of towels, sheets and blankets were available for residents. First aid kit was complete. Facility has sufficient emergency lights/flashlights. Carbon monoxide was tested and observed operation. Smoke detectors were last tested by ADT today.

Facility has an approved mitigation plan and infection control plan.

LPA interviewed one resident and one staff. LPA reviewed 2 resident and 2 staff records.

Deficiencies are cited per Title 22 California Code of Regulations. Failure to submit proof of corrections (POCs) by due dates, and any repeat violations within 12 month period may result in civil penalties.

Exit interview was conducted with Administrator and Appeal Rights was provided.