Facility Evaluation Report

Licensing Program Analyst (LPA) Nadia Shahbazian conducted an unannounced annual required visit and inspection of the facility. LPA met with Jorge Adle Mendoza - Administrator and explained the reason for the visit. The facility is licensed to serve six (6) residents ages 60 and above, of whom (6) may be non-ambulatory. Bedroom #3 has an approved waiver for two (2) hospice residents. Currently the facility has no clients in care.

At 10:45am, with the assistance of Administrator, LPA took a tour of the physical plant. The facility is a one story structure with four (4) bedrooms, two (2) bathrooms, kitchen, dining area, family room, and living room/office area. Required postings were observed in the entry area. The smoke alarms/carbon monoxide detectors are hardwired and interconnected. At 11:05 am smoke alarms/carbon monoxide detectors were tested and observed to be functional. The fire extinguisher is located in the kitchen and was purchased on 7/1/2024. The auditory alarms on all exit doors were functional at the time of the visit.

Common Areas : These included the living room, family room and dining area. LPA observed a double sided fireplace in the family and living rooms; both fireplaces were properly covered by a glass cover. The common areas were properly furnished with tables and chairs for the number of residents.

Kitchen: The kitchen appliances and fixtures were functional. LPA found a sufficient supply of perishable (2 days) and non-perishable (7 days) foods at the facility. Knives were stored in a locked drawer in the kitchen. Chemicals and detergents were stored in a locked cabinet underneath the sink.