Facility Evaluation Report

On 10/16/24, Licensing Program Analysts (LPA) L. Salazar and M. Medina arrived to the facility unannounced to conduct the required Annual Inspection Visit. LPA was greeted by Staff S1, stated the purpose of the visit and was allowed entry into the facility. LPA Salazar will conduct the physical plant portion of the inspection. LPA Medina will conduct the records review portion of the inspection and document on a separate report. Administrator on record is Patrick Nankil, Certificate# 7003773735 , Exp. 03/18/24.

LPA conducted a tour of the facility inside and out with Administrator. LPAs observed 1 resident in care at the time of visit. Facility is a 5 bedroom 3 bathroom home. Residents bedrooms were observed to have the required lighting and furnishings and were free from odor and free from any passageway obstruction / fire hazards. Facility temperature was 74 degrees F. Night lights were observed in the hallways. Window blinds, baseboards and walls throughout the house are observed with dust/dirt and/or partially painted. Padlock hasp / door latch (without a lock) was observed on a kitchen cabinet, hallway closet and laundry room exit door and are being removed.

Medications were observed to be locked in a cabinet located in the kitchen. The baseboard in the nook of the kitchen is dirty and separating from the wall. Cleaning supplies were observed to be locked under the kitchen sink. LPA toured the kitchen observed the required 7-day supply of non-perishable food and 2- day supply of fresh perishables. Bags of rice were observed open and improperly stored There is 1 out of 4 residents with a modified diet. There are no resident's with restricted health conditions.

Bathrooms were toured and observed to have operational lights, running water, and non- slip floors. Hot water temperature tested at 109 degrees F. Trash cans with lids and hand washing postings were not observed in the bathrooms. Personal shower scrubs were observed hanging from the toilet paper holder next to the toilet.

Carbon monoxide and smoke detectors were tested and observed to be operational. Fire Extinguisher was observed with a service date of 10/06/24. First aid kit was observed and contained all required items. Internet and a working phone line was observed to be available for residents in care, however, there is no device for telecommunications.

Quarterly Emergency Disaster Drill logs were observed for staff to have occurred in June 2024. LPA observed on the LIC 610D (Emergency Disaster Plan) with emergency numbers and evacuations locations was posted in the kitchen. A sample of P&I of records was reviewed by Service Coordinator from Kern Regional observed to not balance and no receipts were observed for purchases.