Facility Evaluation Report

Licensing Program Analyst (LPA) Sarah Hurt conducted an unannounced visit today for the facility’s annual inspection. LPA met with Administrator Jose Cortez, and Alfred Tovar, Continual Administrator's Certification for Jose Cortez expires 04/29/2026. There are currently 3 residents who reside at this home and there is 0 residents on hospice at this time. LPA inspected the interior and the exterior of the facility including the common living spaces, resident bedrooms and bathrooms, activity rooms, medication storage, kitchen, and outdoor areas. There is a locked storage for medications. Food supply is adequate for 2-day perishable and 7-day nonperishable.

Fire extinguisher is within the safety regulation period. Smoke alarms were tested and are operational. The home has a carbon monoxide detector and performs disaster drills as required. First Aid kit is on site and complete. Toxins and cleaning supplies are locked and inaccessible. LPA reviewed facility Infection Control Plan, Emergency disaster plan, Plan of Operation, and a sample of resident and staff files.

LPA observed the facility Infection Control Plan is has not been updated annually as required, and is not complete. LPA observed the facility Emergency Disaster Plan has not been updated annually as required and is not complete. LPA observed the facility vents, window sills, and blinds to be extremely dusty. LPA observed the residents hygiene holders are dirty. LPA observed the facilities back exit fence closing latch is in disrepair. Resident 1 does not have Physician's Report available in file to review. The facility does not have proof of required Insurance bond for review.

The following deficiencies observed or cited during today's inspection per California Code of Regulations, Title 22.

LPA requested the following documents: LIC 500 Personnel Report, LIC 308 Designation of Administrative Responsibility, LIC 610-E the Emergency Disaster Plan and copy of current Administrator’s Certificate to update the facility file. Listed documents shall be sent to Licensing.

Exit interview conducted with facility Administrator Scott Richards and copy of report left at facility