Facility Evaluation Report

Licensing Program Analyst (LPA) Vaid conducted the annual inspection using the Compliance and Regulatory Enforcement tools. LPA met with caregiver Rebecca Huilar, Administrator Rita Herrera was not available due to sickness, and explained the reason for the visit.

The facility has a capacity of six (6) residents. It is licensed to serve elderly residents aged 60 and above, approved for six (6) non-ambulatory, of which one (1) may be bedridden. Facility approved for two (2) hospice waivers. The facility cares for elderly residents with dementia. Currently, facility has three residents with dementia.

The facility is in a residential neighborhood, a single-story home and consisted of six (6) resident’s bedrooms, four (4) bathrooms, living room, staff room, kitchen, dining room, outdoor laundry, back house for live in staff.

LPA conducted a tour of the facility, reviewed records, and interviewed 1 staff. The following were observed: Currently the facility has three residents. Three (3) out of six (6) occupied bedrooms have the required furniture such as bedframes, dressers, lamps, and chairs. Beds have the required linen, and the linen is in good condition.

There are three (3) bathrooms for residents’ use. Bathroom #1-#3 have the required grab bars in the shower and near the toilet and nonskid mat. The hot water temperature was 107.3-109.4 and 106.3 degrees respectively, which is within the required 105 - 120 degrees.