Facility Evaluation Report

Licensing Program Analyst (LPA) Rachel Bruce arrived unannounced to conduct the Annual inspection. LPA met with caregiver Guadalupe Jimenez (CG) and Raquel Jimenez, Administrator Assistant (ADA) and Caregiver. LPA toured facility with CG and ADA. All four residents were present at the time of visit, none are currently enrolled in day programs. One resident had family visitors at the time of the inspection who expressed they were pleased with the level of care that their husband/father was receiving.

During this inspection of the facility, the following was noted: Resident rooms were clean and contained required furnishings and lighting. Window screens were present in every bedroom and were in good repair. LPA observed required items in the two bathrooms with hot water measuring within regulatory requirements. The resident bathroom had the following issues- Bathtub faucet was leaking, water stain/mold at bathtub faucet area, wooden board covering the bottom of bathroom sink needs to be replaced, hole in wall behind toilet, and handle missing on cabinet under sink. Hallway closets store linen and adequate supply noted.

Resident hygiene supplies were properly stored and available.

The kitchen was toured and observed in good repair. Sharps/knives were properly locked and stored in a kitchen cabinet. Emergency food and water supply stored in hallway closet along with overflow of non-perishable food items. LPA noted 2 days of perishable food and 7 days of non- perishable food. Menu posted on refrigerator and alternative menu items available. There are no residents with special dietary needs at this time.

Medications are centrally stored and locked in hallway closet. Medication dispensing records stored and locked with employee and resident files. First aid kit contains required items and is located in hallway closet with medication.