Facility Evaluation Report

Licensing Program Analyst (LPA) Christina Valerio arrived at the facility unannounced to conduct an annual visit. LPA Valerio confirmed with Administrator Carolyn that 0 residents and staff have displayed any signs or symptoms of COVID-19 in the last 10 days.

LPA Valerio and Administrator Carolyn toured the physical plant inside and outside to ensure compliance of Title 22 regulations. LPA observed resident room to be clean and free of debris. Resident bathroom had required hygiene items, such as soap, hand sanitizer, paper towels, and a trash can with a lid. The common areas of the facility had the required furniture and furnishings. Medication lock box, sharps, and cleaning supplies Emergency exits were not blocked. LPA observed an adequate supply of food and an emergency supply of food located in the pantry and the freezer outside. LPA Valerio went over the facilities emergency disaster plan with Administrator Carolyn. Emergency drills/Fire drill log completed and posted on the wall. Fire Extinguisher is charged with last inspection on 06/21/21. Hot water was measured at 108.1*F, which is within the required range of 105*F - 120*F.

LPA interacted with 1 resident during the visit. Resident was observed eating breakfast, engaging in activities in bedroom, and talking on the phone. LPA Valerio reviewed resident 1 file, 1 staff file during visit, and medication records. Required documents up to date and in file. Administrator Certificate set to expire June of 2022, which administrator stated she is in the process of renewing.

Per California Code of Regulations, Title 22, no deficiencies were observed during this visit. Exit interview was held with Administrator Carolyn Meeks. A copy of the report was given and left a copy for Administrator Carolyn Meeks.