Facility Evaluation Report

Licensing Program Analyst (LPA) Daniel Konishi conducted the required annual inspection. LPA arrived unannounced and was greeted by Jose Diaz (Caregiver) and the purpose for today’s visit was explained. Shortly after Administrator Thomas Trice assisted with the visit. The facility is licensed to serve 6 Non-Ambulatory residents ages 60 and above, with a hospice waiver for 5.

The facility is a two-story home located in Cerritos, Ca (only the downstairs part of the home is licensed). A tour of the facility includes a living room, dining area, kitchen, 4 bedrooms, 2 bathrooms (1 bathroom is within a share resident room), an attached garage with laundry, front yard and back yard.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit, today’s visit and the initial visit and observed the following:

Infection Control: The facility staff are using appropriate hand hygiene and gloves while assisting residents’ medications. Staff are cleaning and disinfecting throughout the day. The facility has sufficient PPE supplies and has an Infection Control Plan maintained at the facility.

Operational Requirements: The facility has an approved fire clearance, there is a plan of operation with required Infection Control Plan and facility maintains the required liability insurance in place.

Physical Plant & Environment Safety: LPA toured facility, residents’ bedrooms were checked and closet/drawer space to accommodate each resident comfortably was available. The front yard is free of debris/hazards and the outdoor and passageways are free of obstruction. No bodies of water were observed at the facility. Hygiene products are readily available for clients. The hot water temperature was tested and measured 113.8 degrees and 114.2 degrees which is within the required range of 105-120 degrees F.