Facility Evaluation Report

Licensing Program Analyst (LPA) Kelly Nguyen arrived unannounced to conduct an annual required inspection and met with Assistance Administrator Alejandria Bautista, and later Administrator (AD) Romulo Bautista. AD later left and gave verbal permission to AD assistance to sign the report.

LPA with Assistance Administrator inspected the facility inside and out including but not limited to 4 resident rooms, 2 bathrooms, dining area, garage, and backyard. LPA observed sufficient supply of perishable and nonperishable foods. Hygiene products, towels, sheets and warm blankets were observed. Bathrooms were observed with grab bars and nonskid mat for safety of residents. Fire extinguisher in the kitchen appears full was last inspected on 8/18/23. First aid kit was complete. Last fire drill was conducted on 4/2/24. Facility has an updated disaster plan dated 4/2/2024.

While conducting physical plant inspection, LPA observed the following:

1. at around 11:30 am, LPA observed unlock detergent and bleach unlock in the garage

At 1:00 pm, LPA reviewed 5 resident files and 2 staff files. 2 out of 2 staff have TB on files, LPA reviewed medication and log.

Deficiencies were cited per Title 22 California Code of Regulations.

Exit interview conducted; Appeal Rights provided via email.