Facility Evaluation Report

On 1/11/22 at 11:38am, Licensing Program Analyst (LPA) Shira Stamps met with Administrator Monica Vartanian for an unannounced one (1) year required visit for this facility.

LPA arrived at 11:38 am and was greeted by the Administrator. Two (2) residents were observed to be in the living room watching TV. LPA informed the Administrator of the purpose of the visit.

Infection control: LPA reviewed facility mitigation plan (approved on 01/30/21) to make sure the Administrator was following current infection control recommendations. Upon arrival LPA was screened by the Administrator and was asked infection control question. The Administrator signed LPA in and sanitizer was available.

A tour of the physical plant was conducted with the Caregiver, Sambria Peralta at 11:40 am. The facility has five (5) bedrooms, with one (1) room for staff, and two (2) bathrooms currently occupying three (3) residents. The facility is Fire Cleared for six (6) ambulatory.

LPA observed all rooms to have the appropriate bedding. There is a night stand and sufficient lighting for each bedroom.

At 11:50 am LPA observed all bathrooms to have non-skid matts, grab bars, and paper towels. Hot water was tested at 11:56 am and measured within regulation at 117.4°F.