Facility Evaluation Report

Licensing Program Analysts (LPAs) A. Gomez and K. Nguyen conducted an unannounced 1-year Required visit on this date. LPAs met and toured with Administrator, Sheila Melencion . The Administrator currently holds a certificate (#602427740 ) that expires on 5/11/2023 and is currently in process of receiving new certificate . The facility’s fire clearance was approved for a capacity of 18 which 16 may be non-ambulatory and subject to five (5) hospice waivers.

LPAs toured the facility with Administrator including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 71 degrees Fahrenheit. LPAs observed lighting in all rooms that are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 116.2 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of 2-day of perishable foods and a minimum 7-day non-perishable foods.