Facility Evaluation Report

At 10:10am Licensing Program Analysts (LPAs) Perchui Milena Khurshudyan and Ngo-Castaneda, Leslie

conducted an unannounced annual inspection at the facility mentioned above. LPAs met with facility administrator Cindy Garcia, who granted access to the facility. At approximately, 10:20am physical tour was conducted LPAs observed the following:

Bedrooms : At approximately 10:20am LPAs checked the bedrooms. There are four (4) bedrooms designated for 4 clients use. All rooms were observed to have sufficient lighting, and are properly furnished, clean and have appropriate bedding and linens. There is enough linens to be change every week or when necessary in a cabinet in the hallway.

Bathrooms : At 10:25am LPAs observed two (2) bathrooms, all bathrooms are clean and in good repair. Properly supplied with

toilet papers, soap and paper towels. For bathroom #1 that is located beside bedroom #1 has a hot water temperature measured at 115°F. Bathroom #2 that is beside bedroom #3 in the hallway has a hot water temperature that measured 111.°F. LPAs observed appropriate grab bar and had non-skid mat. LPAs observed appropriate hand washing signs posted in each

bathroom. All trash cans in bathrooms had fitted lids to protect from cross contamination.

Kitchen : At approximately, 10:30am LPAs toured the kitchen area and observed enough supplies of staple non-perishable for minimum 1 week and perishable for 2 days at the facility. Canned non expired food was stored in kitchen pantries. All knives and sharps are observed to be locked in a locked staff room in locked drawer and inaccessible to residents. The facility has a working gas stove, microwave, refrigerator and freezer.