Facility Evaluation Report

Licensing Program Analyst (LPA) Cynthia Chan conducted the annual inspection. LPA arrived unannounced and met with Staff, Naylet Velazquez. Administrator, Rosalie Sandoval, arrived shortly thereafter to assist. The purpose for the visit was explained. The facility is licensed to serve 60 non-ambulatory residents ages 60 and over. There is a hospice waiver approved for 5 residents.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following:

Infection Control: The facility staff are using appropriate hand hygiene and wearing gloves while assisting residents. Staff are continuing to clean/disinfect every 2 hours as documented. Facility has sufficient PPE supplies and has an Infection Control Plan. They are continuing to follow the strictest guidance for any infectious outbreaks.

Operational Requirements: The facility does not accept or retain residents with dementia. There are currently 30 residents residing at the facility. The facility has the sufficient amount of liability insurance covering injury to residents.

Physical Plant & Environment Safety: The facility has 30 resident rooms and shared bathrooms. There are no swimming pool or bodies of water at the premises. LPA selected 5 random rooms to inspect: #6, #15, #18, #31, and #32. The bedrooms have the required furniture and sufficient lighting. The hot water temperature was measured in each of the bedroom's sink. They were all within the required range of 105-120 degrees F. The smoke detector is interconnected and there is an operable carbon monoxide detector. The facility does not have a kitchen on site. Foods are cooked at the sister facility next door and is brought over during meal times.

Staffing : There is sufficient staffing at the facility. The administrator's (Rosalie Sandoval) certificate expires on 1/24/24. Staff employed are over the age of 18 and are fingerprint cleared and associated to the facility.