Facility Evaluation Report

Licensing Program Analyst (LPA) Ashley Calderon conducted an unannounced annual inspection visit. LPA met with Administrator Vincent Gonzaga and shortly with Donato Rodriguez / Facility Director, whom assisted with the visit. The facility is licensed to serve one hundred & twelve (112) non-ambulatory residents, ages 60 and above. The facility has an approved five (5) hospice waivers. Currently (0) residents are on hospice. 23 Independent residents and 28 assisted living residents.

During the visit, the CARE tool was used, a tour of the facility was conducted with Donato. The facility locates at a residential neighborhood, consists of three (3) buildings with fifty-six (56) resident rooms.

Food supply was reviewed sufficient perishable and non-perishable food items observed, total of 3 freezers and 3 refrigerators, thermometers in place. Separate room in kitchen for locked cleaning solutions and disinfectants. LPA Calderon alongside with LVN Jacqueline Giron reviewed Medication Record and medications for a total of 4 residents. 23 residents need assistance with medication and are stored in med room, no deficiencies were observed. Medication Room had sufficient PPE. Resident rooms consists of a bedroom, living room, dining area, kitchen, bathroom and walk-in closet. LPAs visited resident rooms #A-108, A-113, B-103, B-106, and C-102,C-106 and C_112. Bathrooms are clean and operable with grab bars and non-skid surface mats/strips. Hot water temperature is in a range of 111.1 to 119 degrees Fahrenheit which is within Title 22 Regulation guidelines. Adequate linen and personal hygiene supplies are in stock in Building M1. Total of 4 laundry rooms for residents and one laundry room for staff use.