Facility Evaluation Report

On 12/19/24, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct an annual visit.

introduce self, stated the purpose of the visit and met with staff Sonia Bautista. Licensee/Administrator Leticia Jackson was called and arrived shortly. All five residents were present during inspection. Residents were observed in the common area and in the bedrooms. LPA toured facility with Licensee.

The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside or outside. All residents’ bedroom were toured and observed to have the required furnishings and with adequate lightening. At 10:24AM, medications were observed on side table and television stand in room 1 unlock. At 10:29AM, medications and alcohol bottle were observed in room 2 closet unlock. Alcohol bottle was observed in staff closet in living room unlock.

Fire extinguisher was observed with a service date: 01/18/24. LPA toured kitchen and observed cleaning chemical stored under kitchen counter unlock. Discontinued medications were observed stored under kitchen counter next to stove unlock.

An adequate supply of perishable and non-perishable food was observed. Refrigerator temperature is maintained at 32 degrees F and freezer at -3 degrees F.

Washer observed operational during visit. At 10:51AM, LPA observed a large box fill with cleaning bottles stored in the garage unlock. Refrigerated medications were observed in mini refrigerator unlock in the garage next to large chemical box. Knives were observed stored in a metal cabinet in the garage unlock. Paint cans were observed in the garage back wall unlock.