Facility Evaluation Report

Licensing Program Analyst (LPA) Tena Herrera conducted the required annual inspection. LPA arrived unannounced and met with Caregiver April and explained the purpose for today’s visit, shortly after Administrators Elsa and Ivonne arrived to assist with the visit. The facility is licensed to serve 6 non-ambulatory residents ages 60 and over with an approved hospice for 4 residents.

The facility is a single-story home located in Lakewood, Ca. A tour of the facility includes: living room, dining area, kitchen, laundry area, activity/tv room, 5 bedrooms, 2 bathrooms, attached garage. front yard and back yard.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit todays visit and the initial visit and observed the following:

Infection Control: Facility maintains the required Infection Control Plan and its reviewed yearly.

Operational Requirements: The facility has an approved fire clearance proof of the required liability insurance was provided.

Physical Plant & Environment Safety: LPA toured facility, residents’ bedrooms were checked and closet/drawer space to accommodate each resident comfortably was available. The front yard is free of debris/hazards and the outdoor and passageways are free of obstruction. No bodies of water were observed at the facility. There are no security bars or weapons on the premises. The hot water temperature was tested and measured within the required range of 105-120 degrees F. All storage areas for cleaning solutions, toxins, knives, hazardous items are kept locked and are inaccessible to residents. Smoke/carbon monoxide detectors are operable and in compliance. There fire extinguisher was observed and is fully charged.