Facility Evaluation Report

Licensing Program Analyst(s)(LPA) Mary Flores conducted a case management visit to follow up on corrections needed during pre-licensing visit conducted on 9/12/22. LPA Flores met with Brianna Goodlet - applicant's representative.

On 9/12/22 LPA Flores, Mora, and Ramirez observed the following corrections needed:

Applicant is to fix the loose outlet cover plate in room #145 and hole in the wall in room #103.

Applicant is to ensure the water temperature is maintain between 105 and 120 degrees F. in rooms #160, 159, 156, 153, 152, 150, 149, 145, 141, 139.

Applicant is to ensure bathrooms in rooms #141 and 153 have skid strips/mats.

Applicant is to ensure resident #1(R1) in room#155 and resident #2(R2) #256 do not store medication in their rooms.

On 10/17/22 LPA Flores conducted a tour with Gina Lopez - staff and observed the following:

Water temperature in rooms # 160, 159, 156, 153, 152, 150, 149, 145, 141, 139 was tested and tested between 110.3 to 117.8 degrees F., which is within the required water temperature.

Skid strips were observed in rooms #141 and 153 showers.

No medication observed in room #155 and in room #256 resident #2 has medication but an updated physician's report dated 9/19/22 indicates resident can stored on medication.

Physical plant is following Title 22 Regulations. Exit interview was conducted with Brianna Goodlet - Applicant's Representative and a copy of this report was provided.