Senior Care Records.

Facility Evaluation Report

Humble Haven RCFE IV, Palmdale11/01/2024Licence 197610333

Capacity6
Census5
Date signed11/01/2024 03:50:14 PM
The inspector’s account

Licensing Program Analyst (LPA) Melissa Spaeth conducted an unannounced visit on 11/01/2024 and was greeted by the caregiver. The Administrator Nicole De Las Alas was called. LPA stated the purpose of the visit was to conduct an annual inspection. The caregiver confirmed there are five residents. The facility is licensed for five (5) non-ambulatory residents and one bedridden resident.

LPA Spaeth and the caregiver toured the facility at 10:00 am until 10:30 am.

Common Areas – The family room, dining room, and kitchen are combined. The family room was furnished with comfortable seating and a television. The dining room area contained a dining room table and chairs.

Kitchen - LPA Spaeth observed a two-day supply of perishable food and a seven day supply of non-perishable food. The knives were locked. The cleaning solutions were locked underneath the kitchen sink. The fire extinguisher is located near the kitchen and is operable.

Medications: LPA observed the resident medications, first aid kit, and PPE supplies were safely locked in a kitchen cabinet

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