Facility Evaluation Report

Licensing Program Analyst (LPA) Nune Margaryan conducted an Annual Required visit and inspection of the facility. LPA met with staff David Fontecha. Shortly after Administrator Diana Castellanos arrived and assisted with the visit. LPA explained the purpose of the visit. During the visit, the CARE tool was used. The facility is licensed to serve 6 non-ambulatory residents age range 60 and over, of which 1 may be bedridden and hospice waiver for 6. The facility has 6 bedrooms, 1 bathroom, a dining room, a living room, a detached garage, a detached laundry room, back patio and a front yard.

The facility is a single-story home, located in a residential area, that consists of a living room, dining room, six (6) resident bedrooms, one (1) bathroom, a kitchen, and detached garage. Laundry room was observed at the back of facility. All indoor and outdoor passageways were free of obstruction. The front and backyard are well maintained. No pools and bodies of water on the premises. There is a shaded seating area for the residents located in the backyard. The kitchen was inspected. LPA observed all kitchen equipment to be clean and in working condition. LPA observed sufficient supply of perishable and non-perishable foods. Additional food supplies observed in the garage. Appliances such as a microwave, refrigerator and stove were observed to be clean and operated properly. Sharps are locked and inaccessible to residents. Cleaning solutions and disinfectants was observed locked in the laundry room. The common areas (dining room, living room) are clean and were properly furnished. Resident rooms were sanitary and had the required furniture and furnishings. There is closet space for clothing and other belongings. Extra clean linen were observed in each residents room. The resident bathroom is clean and operational w/grab bars and non-skid surface/mats in place. The hot water temperature was tested and maintained within the required range of 105-120*F. Fire extinguishers were observed at the facility fully charged (1 in the kitchen and 1 in the living room).