Facility Evaluation Report

Licensing Program Analyst (LPA) Christian Gutierrez conducted the annual inspection using the Compliance and Regulatory Enforcement (CARE) tools. LPA met with Caregiver Melchora Naron and explained reason for visit. Administrator Rona Lomeda arrived shortly.

Facility is licensed to serve age range 60 and over. Approved for six (6) non-ambulatory residents, of which six (6) may be bedridden. Waiver granted for hospice care for six (6). Facility has an approved Dementia Care Plan. The facility is a single-story home located in a residential area. The home consists of the following: 5 resident bedrooms, 1 resident bathroom, 1 staff/visitor restroom, living room, kitchen, dining area, nurse station/ laundry room, front yard, backyard, and de-attached garage. There is sufficient indoor and outdoor activity space for residents.

LPA toured the facility and observed the following: Each resident bedroom has the required furniture and bedding. Extra linen and towels were observed in laundry cabinet. The Smoke detectors and carbon monoxide detectors were observed throughout the facility bedrooms #1 and #5 were not working properly during inspection. The facility has one (1) fully charged fire extinguishers which is kept in kitchen. Cleaning supplies and toxic substances were observed to be accessible in entry way closet and bathroom sink. Freezers are maintained at a temperature of 0-degree F and the refrigerators at a maximum of 40 degrees F. Facility was observed to have sufficient supply of 2 days perishable & 7 days non-perishable foods. There are no firearms or weapons stored at the facility. The hot water temperature in the bathrooms were measured between the required range of 105-120 degrees F. The resident bathrooms have the required grabs bars and non-skid mats. The facility does not have a swimming pool or bodies of water on the premises There is a shaded seating area for the residents outside in backyard. Passageways and exits are free of obstruction.