Facility Evaluation Report
Licensing Program Analyst (LPA) Cynthia Chan conducted the unannounced annual inspection. LPA met with the administrator, Jennifer Leon, and explained the reason for the visit. The facility is licensed to serve 6 non-ambulatory residents ages 60 and over, of which 1 may be bedridden. Room #4 is designated for the bedridden resident. There is a hospice waiver approved for 6 residents.
LPA inspected the facility using the Compliance and Regulatory Enforcement (CARE) tools and observed the following.
The single story facility consists of 4 resident bedrooms, 2 Staff rooms, 2 bathrooms, living room, family room, kitchen, office, and an attached garage. The backyard has a shaded area for resident use. The hot water temperature was measured between the required range of 105-120 degrees F. There are no swimming pool or bodies of water on the premises. The facility has a carbon monoxide detector. Sufficient food supplies of 2 day perishable and a week of non-perishable are observed. Facility has sufficient space to provide indoor and outdoor activities to residents. Facility accepts and retains residents with dementia. Staff are ensuring that incontinence residents are changed often and the facility remains free of odor from incontinence. There are currently no residents with prohibited or restricted health conditions. There is no resident using oxygen at this time. Medications are centrally stored and locked in the hallway cabinet. All the residents are givent their medications as prescribed. LPA reviewed 6 resident files and files contain the required documents. LPA reviewed 4 personnel files. The administrator's (Jennifer Leon) certificate expires on 8/8/26. Staff files have current CPR & First Aid certificates, health assessment with TB test results, and on-going annual training. The Emergency Disaster Plan is reviewed annually and has the emergency procedures indicated.
No deficiencies were issued. An exit interview was held and a copy of this report along with appeal rights was given to the administrator.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction