Facility Evaluation Report

Licensing Program Analyst (LPA) Sanjay Vaid conducted an annual required visit. LPA met with administrator Cheryl Carter. Administrator assisted with the tour and record review. LPA used the CARE tool to evaluate the facility. The physical plant was inspected medications, food supply, and resident and staff records. The facility has an approved Mitigation plan and Infection Control plan reviewed. The facility has an active and current liability insurance policy on file. Administrator certificated expires 2/22/2026.

Resident bedrooms were toured. Each bedroom has a smoke detector, bed, linen, dresser, light, and sufficient closet space. Both bathrooms were toured. Bathrooms have the required grabs bars and non-skid mats. The hot water was within the required 105 - 120 degrees. The kitchen appliances are operating properly. There was a sufficient amount of perishable and non-perishable food. The common areas include the living room and dining room. The facility is clean and has the required furniture. The facility does not have any cameras inside or outside the home. Auditory devices were observed at all entrances/exits of the home and were operational.

All 2 resident files were reviewed to confirm emergency contacts and health screenings are updated. LPA reviewed staff files for proof of fingerprint clearance and health screenings. Files were complete and residents' medications were reviewed. Medications are documented daily and given as prescribed.

Facility documents resident, staff and visitor temperatures. Facility also requires visitors to sign-in which are part of the COVID-19 procedures.

Residents were not interviewed, one resident is on hospice and is asleep, second resident is sleeping, both are non-verbal.

Per California Code of Regulations, Title 22, there were no deficiencies observed during the visit. Exit interview held. A copy of the report was provided to administrator.