Facility Evaluation Report

Licensing Program Analyst (LPA) Elena Mallett conducted an unannounced, Annual Inspection. LPA met with Caregiver Arnold Prestano and explained the purpose of the visit. Administrator Hiransha Keerthisinghe was contacted by telephone and joined the visit shortly after. LPA Mallett toured the facility with Caregiver Prestano. Copies of resident and employee rosters were obtained.

The facility is a in the residential community of Cerritos and is licensed to serve 6 non-ambulatory residents, one of which may be bedridden. The facility has a hospice waiver for 4 but only one resident is currently receiving hospice services. The facility consists of a Living room, kitchen, family room, 4 client bedrooms ( 2 shared) and 2 private and 2 bathrooms. There is a front yard and backyard. The backyard contains a shaded patio area for clients to sit. These areas were free from obstruction and well maintained.

The facility hallways and rooms were free from debris and obstructions. There were operable smoke detectors in each resident room and in common areas. There was an operable carbon monoxide detector observed by residents' room. There was a fully charged fire extinguisher present. The kitchen and food supply was observed to have sufficient perishable and non-perishable food as well as operable appliances for food preparation and storage. Knifes and sharps and cleaning supplies and toxins were observed to be locked cabinets.

All resident rooms were observed to have required linens and furnishings and light. Extra linen and hygiene supplies were observed. Water in both bathrooms measured within Title 22 Regulations.

The CARE Tool was utilized for today's visit. Due to Time constraints only the Physical Plant and Food Service domains were completed. The Annual will be completed at a later time.No deficiencies per Health and Safety Code and Title 22 regulations were observed today. An exit interview was conducted with Administrator Keerthisinghe and a copy of this Licensing Report was provided.