Facility Evaluation Report

Licensing Program Analyst(s)(LPA)s Alberto Lopez and Mary Flores conducted an unannounced Case Management visit to follow up on office visit conducted on 04/26/22 regarding Quarterly Case Management visits. LPAs met with Carmen Cunanan Caregiver and was met short later by Administrator Tina Arutytunyan and explained the purpose of the visit.

LPAs Lopez, Flores and Administrator Tina Arutyunyan toured three resident's rooms, common area and outside physical plant. Facility had enough Non perishable food for 7 days and perishable food for 2 days. Water temperature was tested in bathroom #1 at 122.6 degrees F and in the shower at 122.1 by room #3 The kitchen sink was tested 123.7 degrees F., and bathroom #2 at 123.3 degrees F., which is not within the required 105-120 degrees F. LPAs and Administrator observed one knife in the kitchen drawer that was unlocked and cleaning solutions where unlocked and accessible to residents. LPAs reviewed residents files and observed facility has 3 bedridden residents out of 5 residents. Resident #1(R1), #2(R2), #3(R3) have ambulatory status noted as bedridden in physician's report. Administrator stated R1 is bedridden and will discuss status of R2 and R3 with primary physician. Record of Resident's Safeguarded Cash Resource was reviewed for R1.

Deficiencies cited on 809D per Title 22 Regulations.

Exit interview was conducted with Administrator Tina Arutyunyan and copy of report provided.