Facility Evaluation Report

On 02/01/2024 at 12:00 PM, Licensing Program Analyst (LPA) Jose Calderon conducted an unannounced annual inspection visit at the Pepper Tree Assisted Living 2 Facility. LPA Calderon was allowed entry into the facility by Staff Mario Pangan. Staff Mario Pangan was asked questions regarding the full care tools control package (13) sections. Staff Mario Pangan took LPA Calderon temperature prior to entrance into the facility. Facility is licensed for (6) non-ambulatory residents. LPA Calderon explained to Staff Mario Pangan, the purpose of the one-year (1) Annual Inspection visit, and escorted LPA Calderon on a tour of the entire inside and outside facility grounds. As part of the inspection, LPA Calderon reviewed: six (6) resident service records, six (6) resident medication records, two (2) staff records. LPA Calderon interviewed six (6) residents and two (2) staff members for visit. LPA Calderon inspected the inside facility and outside grounds to include all common areas. The facilities’ last fire drill was conducted on 11/03/2023 . The two-story residential home consists of five (5) resident bedrooms, three (3) resident bathrooms, living room, dining room, family room, kitchen, office area, attached garage with washer and dryer/ storage area, backyard with table and chairs. No weapons are stored in the premises. Kitchen was inspected and observed to be clean and operational. A two-day (2) supply perishable and seven-day (7) supply of non-perishable foods are present in the facility. Emergency Water seven-day (7) supply is found in the garage.