Facility Evaluation Report

Licensing Program Analyst (LPA) Tao conducted an unannounced annual inspection visit. LPA met with Alondra Fuentes, Administrato r who assisted with the visit. The facility has a capacity of 90 residents. It is licensed to serve elderly residents age 60 and above, approved for fifty-six (56) non-ambulatory residents. The facility has eight (8) hospice waiver on file. Two (2) residents are on hospice. Facility has five (5) dementia residents. Annual fees are current. Administrator certificate is current, expires on 08/14/2023.

During the visit, the infection control domain tool was used, a tour of the facility was conducted, food supply was reviewed, and medications were reviewed.

The facility is a two-story building with 63 resident rooms. LPA toured resident rooms #105, #123, #128, #227, #231 and #236. Resident rooms consisted of a bedroom, bathroom and closet. Bathrooms inspected were clean, operable, with the required grab bars and non-skid materials in the shower. Hot water temperature was measured in a range from 106.5 to 115.9 degrees Fahrenheit which was within Title 22 Regulation guidelines. Adequate linen and personal hygiene supplies were observed.