Facility Evaluation Report, 10/06/2022 — Holy Hill Inc-mapledale Home, Norwalk CA

On 10/6/2022 Licensing Program Analyst (LPA) Ashley Calderon made an unannounced visit to Holy Hill Inc-Mapledale Home. The purpose of today’s visit was to conduct the Required 1 Year inspection. On today’s visit LPA Calderon was allowed entry into the home and met Caregiver Karen De Los Reyes. Caregiver Benita Guinto was also present. The home is licensed for 3 non-ambulatory clients. Facility also has a hospice waiver for 1 client, no client on hospice at the time. The last fire drill was conducted on 09/01/2022.

At 9:40 pm LPA Calderon conducted the tour of the physical plant along with De Los Reyes. The one story home consists of 3 client bedrooms, 2 bathrooms, living room, dining room, kitchen, backyard and the attached garage that is used for storage and remains locked. LPA and De Los Reyes first toured the kitchen the hot water temperature read at 108.4, the refrigerator had sufficient non-perishable and perishable foods, fire extinguisher is charged, sharp items, cleaning supplies and medication cabinet that are all stored in the kitchen cabinets were locked and inaccessible to clients. Common bathroom hot water read at temperature of 106.3, hallway had laundry room which laundry is done by staff, oxygen monoxide and fire alarm system are properly working. C1 bedroom observed it to be within Title 22 regulation. C2's bedroom was observed it to be within Title 22 regulation as well as C3's bedroom. All contained proper bedding, bed linen, comforters, pillows, adequate lighting, space for clothing and personal items, a chair and rooms are clean and in good repair. C3's room has a private bathroom hot was temperature read at 109.7.

Home had a comfortable temperature of 76 degrees F, floor in good repair, all rooms remain clean , bathrooms well stocked, sufficient toiletries for clients when needed is available. LPA Calderon toured the outside grounds and no bodies of water were observed. A shaded area with plenty of seating for clients was observed. Exits/ Walkways around the home were free of debris and hazards.