Facility Evaluation Report

On 02/28/2024 at 9:30 AM, Licensing Program Analyst (LPA) Avelina Martinez made an unannounced visit to this facility to conduct an annual required inspection. LPA Martinez met with Rosauraora Nguyen and Karen Puente and Phoenix Lee Nguyen and explained the purpose of the visit.

LPA Martinez inspected the physical plant including but not limited to the kitchen, dining room, resident bedrooms; resident bathrooms, laundry room, activity room, and outside courtyards of the facility to ensure compliance with Title 22 regulations.

Administrator holds current certificate and expires on 10/14/2024. The facility is licensed for 4 ambulatory clients, of which 1 may be non-ambulatory. There is currently 1 client who reside at this facility.

The LPA Martinez toured the facility with Rosauraora Nguyen and Karen Puente on 02/28/2024 at 10:20 AM.

LPA Martinez reviewed 1 client file and 2 staff files, and all files were complete. LPA Martinez reviewed 1 Medication Administration Record (MAR), and the MAR was maintained. The water temperature measured at 118 degrees. The facility temperature measured at 70 degrees. The fire extinguishers, smoke detectors. and carbon detectors are in good repair. The last fire drill was February 2024. The exterior of the home is clear of debris, and emergency exit gate is in good repair. The facility first aid kit is complete. The facility is sanitary and clean and furnished. Resident bedrooms are furnished and sanitary. The facility bathrooms are sanitary. The facility kitchen is sanitary, and the facility has an adequate food supply. The facility also has emergency water kit.

Based on observation on today's annual inspection, the facility is in compliance with California Code of Regulations, Title 22 and Health and Safety Code, there were no deficiencies cited at this time.

An exit interview was conducted, and a copy of this report was given to the facility at the end of the visit.