Facility Evaluation Report

On 04/29/25, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit, and met with Licensee/ Administrator (L1) Socorro Ann Telmo. LPA toured facility with L1. All five residents were present during the inspection.

The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside. Washer observed operating during visit. Chemicals observed locked under kitchen sink and garage cabinet. Knives stored and locked in kitchen drawer. Medications observed stored and locked under kitchen counter. Residents’ MARS and Centrally Stored Medication Records were reviewed. Medications were checked. Fire extinguisher was observed with purchased date of 03/01/25. LPA observed 2-day perishable food was observed and 7 day non-perishable food. Freezer temperature maintained at 0 degree F and refrigerator temperature maintained at 32 degrees F. Extra linens were observed. Residents' bedrooms were toured and observed to be adequately furnished with bed, dresser, and adequate lighting. All bathrooms are observed with securely fastened grab bars and non-skid mat. Hot water temperature was tested at 110.7 and 110.1 degrees F in master bedroom bathroom and 107.4 degrees in hall bathroom. Outside of facility toured and observed free of debris. Adequate outdoor seatings observed available for the residents. A sample of staff and all residents’ files were reviewed. Carbon monoxide and smoke detector operational during visit.

A deficiency is being cited on the attached 809D in accordance to California Code of Regulations, Title 22, Division 6.

Exit Interview conducted. LPA received copies of: Lic 308, Lic 500, Lic 610E, current Administrator certificate, and current liability insurance. A copy of this report and appeal rights was provided to Licensee, whose signature on this form confirms receipt of this report.