Facility Evaluation Report

Licensing Program Analyst (LPA) Shira Stamps met with Administrator Valeree Zepeda for an unannounced one (1) year Required visit for this facility. LPA arrived at 11:50 am and was greeted by caregiver, Soccoro Caballero The Administrator arrived at 11:53am, and LPA informed the Administrator of the purpose of the visit.

Infection control: LPA Stamps reviewed facility mitigation plan (approved on 02/13/21) to make sure licensee was following current infection control recommendations. Upon arrival LPA was screened by the Caregiver. Sink was available to wash hands.

A tour of the physical plant was conducted with the Administrator at 11:55 am. The facility has four (4) bedrooms and two (2) bathrooms currently occupying four (4) clients. One (1) bedroom and one (1) bathroom are designated for staff use only. The facility is Fire Cleared for four (4) ambulatory and two (2) non ambulatory. All clients were observed to be in the dining area eating lunch.

LPA conducted a tour of the kitchen around 11:57 am and observed there to be sufficient stock of two-day perishables and seven-day non-perishables foods. Frozen foods are properly wrapped and stored appropriately. Food storage and preparation areas care clean and inaccessible to pests. LPA observed an extra refrigerator and deep freezer in the garage.

LPA observed staff washing client’s bedding the time. LPA observed appropriate bedding sheets and blankets in the hallway closet. There is a nightstand and sufficient lighting for each resident.

At 12:00 pm LPA observed all bathrooms to have non-skid matts and the appropriated wash your hands signs posted will be posted in the client’s bathroom. Hot water was tested at 12:04 pm and measured within regulation at 113.8 degrees F.