Facility Evaluation Report

Licensing Program Analyst (LPA) Angela Barutyan arrived at the facility unannounced to conduct a required annual visit at 11AM. LPA met with House Manager Ana Marie Leyva upon arrival. Administrator Ann-Hazel Lopez was contacted by phone during the visit but was unable to be present for the visit. Entrance interview conducted.

At 11:06AM, the LPA along with the House Manager, toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations.

KITCHEN/GARAGE: LPA inspected the kitchen/food service area at 11:06AM. Kitchen appliances appeared clean and were in operable condition at the time of the visit. The facility has a sufficient supply of perishable and nonperishable food. Food labels were inspected and checked for expiration dates and food labels had expiration date clearly marked. Knives and chemicals were locked and inaccessible in kitchen drawer and cabinet under the sink. LPA observed a locked garage by the living room containing emergency food and water supply, additional refrigerator and freezer, washer and dryer, and supplies.

BEDROOMS: There are five (5) private resident bedrooms. There is one (1) staff bedroom which was observed locked. LPA observed resident bedrooms to be furnished appropriately with clean linens, appropriate furnishings, sufficient lighting, and equipped with functioning auditory exit alarms.

RESTROOMS: There are four (4) bathrooms; three (3) are attached to resident bedrooms and one (1) is a full bathroom in the hallway for residents, staff, and guests. LPA observed resident restrooms equipped with grab bars and slip-resistant surfaces. Hot water temperature was measured in all restrooms and were between 106.0-111.2 degrees F, which is within the required range. Report Continued on LIC 809-C.