Facility Evaluation Report

Licensing Program Analyst (LPA) Nicol Wesley conducted an unannounced Required 1 year inspection at the facility and met with Administrator Archimedes Lopez and explained the purpose for todays visit. Prior to the visit LPA Wesley conducted a risk assessment for on-site inspections. The facility phone number is 562 924 4394. During the visit Assistant Administrator Mira Lopez arrived and joined the visit.

The facility consist of three resident bedrooms, two bathrooms, a living room, dining room, activity/office area, kitchen, back yard(patio with tables and chairs), and an attached garage(storage).

During the visit the Infection control domain was used and the following areas were observed/inspected: The facility had all postings at the front entrance, bathrooms, and throughout the facility. Hand sanitizing gel and masks were located at the entry of each room. A Pre screening area with PPE supplies was observed upon entry into the facility.

LPA conducted a complete tour of the facility, and observe the supply of food. Resident medications, and medication logs were reviewed. The smoke detectors/carbon monoxide detector are operable. LPA observed one fire extinguisher in the kitchen. The water temperature was tested and measured 106 degrees F. The mitigation plan was received on 03/08/2021.