Facility Evaluation Report

Licensing Program Analyst (LPA) Leslie Ngo-Castaneda conducted an continuation annual required visit and inspection of the facility. At 12:07 PM Marissa Flores who is the staff designee met with LPA, explained the reason for the visit.

At 12:10 PM, with the assistance of staff, LPA took a tour of the physical plant. Required postings were observed in the entry area. The smoke alarms are operational that are located each bedroom, the hallway and kitchen. There are carbon monoxide detectors that functions properly. The fire extinguisher is in the kitchen. The charge date is 11/20/2024. During the visit the facility is at 69 degrees Fahrenheit. The facility is fire cleared for five (05) non-ambulatory residents; one (1) may be bedridden and is cleared for six (6) hospice waiver.

Kitchen: The kitchen appliances and fixtures were functional. The kitchen has a working gas stove, faucet, freezer, refrigerator, and microwave. LPA found enough at least two (2) days perishable and seven (7) days non-perishable food at the facility that is properly stored. Frozen foods are wrap, dated, and stored properly as well. Knives were stored in a locked drawer in the kitchen. Food storage and preparation areas are clean and inaccessible to pests. Garbage cans have tight fitting covers. Cleaning supplies, pesticides or toxic cleaning supplies were stored and are locked away under the kitchen.

Bedrooms: There were six (6) bedrooms designated for residents' use. Bedroom #1, bedroom #2 (vacant), bedroom #3, bedroom #4 (vacant), bedroom #5, and, bedroom #6 (vacant) are for private used by residents were properly furnished with appropriate dresser, beddings, and linens with sufficient lighting.