Facility Evaluation Report

On 6/26/2024 at 2:30PM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a Required - 1 Year inspection. LPA met with Caregiver, Carlota Moises and explained the purpose of the visit. Administrator, James Santos arrived an hour later.

LPA toured the facility including but not limited to bedrooms, bathrooms, dining area, kitchen, garage, and outdoor area. Smoke and carbon monoxide detectors were observed. Fire extinguisher was observed to be full and last serviced on 8/15/2023. One week of nonperishable and 2-day of perishable food supplies were available. LPA observed grab bars and non-skid mat in the bathrooms. There were adequate lights in each room. Resident rooms were observed to be cleaned and fully furnished. First Aid kit is complete. Indoor and outdoor passageways were free of obstruction. No bodies of water observed.

LPA reviewed 3 residents and 3 staff files starting at 3:00PM. LPA interviewed 2 residents and 2 staff. LPA reviewed a sample of resident's medications starting at 4:00PM.

At 2:45PM, LPA measured hot water measured at 127.5 degrees F in the hallway bathroom.

At 4:30PM, LPA observed facility does not have disaster drill documents

The deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22 and Health & Safety Code. Failure to correct the deficiencies may result in civil penalties.

Exit interview conducted. A copy of this report and appeal rights were provided.