Facility Evaluation Report

Licensing Program Analyst (LPA), Mayra Cota, conducted an announced annual visit. LPA contacted, DeAngela Santos, Licensee via phone call and explained the reason for the visit. Lorena Palafox, Administrator, arrived to the facility thereafter and assisted with today's visit.

Facility is licensed to serve (6) non-ambulatory residents in the age range of 60 and over. Facility currently has no residents or staff.

The facility is in a residential area of Lakewood, CA. During the visit, LPA toured the facility's indoor and outdoor environment and reviewed one (1) staff file. The facility is a single-story house which consists of: living room, dining area, kitchen, (3) resident bedrooms, (2) bathrooms, office/medication room, laundry area in the garage, front and backyard/patio, and attached garage.

Facility was observed clean and all walkways and passageways are free from debris and clear of obstructions. Front and backyard are well maintained and the backyard patio has a shaded area readily available for residents. Patio furniture is in good repair. Living room and dining area have enough seating for residents. Kitchen appliances are clean and were operating at the time of the visit. Sharps were observed locked in a kitchen cabinet. Chemical and cleaning supplies are kept locked in the garage. Sufficient food supplies for at least 2 days of perishables and 7 days of non-perishables were observed in the kitchen.

First Aid kit is kept in the kitchen, was observed stocked with all required items including a current manual. Clean towels and extra clean linen were observed in the hallway closet. Resident bedrooms have the required furnishings and bed linen, ready for residents to use. Bathrooms were inspected and were observed clean and sanitary. Water temperature was measured and observed to be within compliance range of 105 - 120 degrees F. Personal hygiene products are readily available and stored in bathroom cabinet.