Facility Evaluation Report

On this day, April 25, 2023, at 11:45 a.m., Licensing Program Analyst (LPA) Delmundo arrived unannounced to conduct an annual required inspection. LPA was granted entry by staff, Mary Grace Rentoria. LPA informed the reason for visit. LPA met with Evelyn Marquez, administrator, after several minutes. LPA also met with other staff, Lydia Alvarez. All these staff were fingerprinted, and associated to the facility.

LPA inspected the facility inside and out including but not limited to living room, dining area. kitchen, bedrooms, bathrooms, laundry area, staff rooms, front, side and backyard. Facility has sufficient perishable and non-perishable foods. Fire extinguishers were observed fully charge with tags showed serviced February 2, 2023. Facility has 2 in 1 carbon monoxide and smoke detector that was observed operational. Hot water temperature in the common bathroom was tested. Facility conducts fire drills monthly, and records showed last conducted April 19, 2023.

LPA reviewed 4 residents and 5 staff files, and interviewed 2 residents and 2 staff. Medications were checked and compared with records . Storage for medications and sharps were observed locked.

-at 12:11 pm, expired macaroni salad (expiration: 4/17/23)

-at 12:18 pm, hot water temperature at 139.8 degrees Fahrenheit

-at 12:22 pm, uneven surface between the wood flooring and cement ground area in the backyard. According to administrator the contractor is scheduled to come back to finish the job.

-at 2:50 pm, residents' records of cash resources not complete for all residents.

-at 3:00 pm, administrator was interviewed who stated facility does not maintain LIC622 Centrally Stored Medication and Destruction Record.

-at 3:15pm, 3 out of 4 residents are over 60 years of age