Facility Evaluation Report

At 9:47 AM, Licensing Program Analysts (LPAs) Huma Rahimi and Leslie Ngo-Castaneda conducted an unannounced annual inspection to the above facility. LPAs were greeted at the front desk and met with the Administrator Susan Park. LPAs explained the reason for the visit. LPAs and the Administrator toured the facility inside and out and observed the following:

The Administrator had to leave and the General Manager Brenda Chacon was designated to sign today's report.

The facility is a single story building with private and shared bedrooms, private bathrooms, kitchen, dining room, recreation room, common area, patios, and outdoor areas. The facility is licensed for 98 residents ages 60 and over. The fire clearance is approved for 98 non- ambulatory residents of which 15 can be . There is a hospice waiver approved for 10 residents.

Bedrooms: LPAs and Administrator toured vacant and occupied bedrooms. Rooms # 46, 50, 80, 47 28, 38, and 22 were inspected. LPAs observed lamps, nightstands, beds, linens, and private bathrooms with liquid soap, hand towels, and trash cans.

Bathrooms: The facility currently has two common restrooms. Additionally, staff has their own private bathrooms. The bathroom was sanitary with liquid soap, paper towels, handwashing instruction sign, and a trash can with a tight-fitting lid. At 9:55 AM, LPAs measured the hot water temperature of a private resident bathroom in room #46 to be 106.3F.

Common Areas: All floors, walls, and ceilings were clean. Furniture in the dining room, lounges, living room, and activity room were clean and in good repair. At 10:00 AM LPAs measured the room temperature to be 72 F. Continue on LIC 809C