Senior Care Records.

Facility Evaluation Report

Humble Haven RCFE III, Palmdale10/14/2021Licence 197610205

Capacity6
Census0
Date signed10/14/2021 12:31:31 PM
The inspector’s account

LPA Spaeth conducted a Comp III presentation and pre-licensing visit and was met at the front door by the Administrator, Nicole De Las Alas. LPA observed the required COVID signs posted on the front door. LPA observed the Administrator was wearing a mask. LPA's temperature was taken and the COVID questions were asked by Administrator. LPA signed in and observed hand sanitizer and masks available for use.

LPA conducted the Comp III presentation from 10:05 am until 10:20 am. The tour began at 10:22 am. LPA checked the water temperature in bathroom #1 and recorded the temperature to be 107.8 F at 10:24 am.

Resident bedrooms - LPA observed six bedrooms which contained a bed, linens, chest of drawers, night stand, night lamp, and chair in each room. Each room was specious and clean. LPA observed bedroom #5, which is designated for a bedridden resident. LPA observed the exit door contained the alarm and was tested operable at 11:36 am.

Kitchen - LPA observed the kitchen contained the wash your hands sign, hands soap, paper towels, and trash can. LPA observed an adequate supply of fresh vegetables, fresh fruits, dairy products, and frozen meats within the refrigerator. LPA observed the pantry contained an adequate supply of canned goods. The Administrator unlocked the cabinet underneath the kitchen sink and observed the cleaning supplies stored in the cabinet. LPA observed the locked cabinet which is designated for resident medications. LPA observed the fire extinguisher located in the kitchen.

Bathrooms - LPA observed three bathrooms which contained wash your hands sign, hand soap, trash cans, grab bars, and slip resistant mats. All bathrooms were neat and clean.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction