Senior Care Records.

Facility Evaluation Report

Mar Vista Manor, Pasadena03/01/2022Licence 198601500

Capacity6
Census5
Date signed03/01/2022 02:06:34 PM
The inspector’s account

Licensing Program Analyst(s) LPA Mary Flores conducted a plan of correction (POC) visit at the facility to follow up on deficiencies given during annual visit on 2/15/22. LPA Flores met with Kimberly Isaac assistant administrator and explained the reason for the visit.

On 2/15/22 during an annual visit LPA Flores gave the following deficiencies:

Section 80087(g)(1) Building and Grounds - cleaning solutions were observed unlocked in kitchen cabinet. On 3/1/22 LPA Flores observed cabinet with lock and staff opened cabinet to utilized supplies.

Section 80088(e)(1) Fixtures, Furniture, Equipment, and Supplies - water temperature in bathroom #1 was tested at 132.5 degrees F and in bathroom #2 tested at 133.2 degrees F which is not within the required 105-120 degrees F. On 3/1/22 LPA Flores tested water temperature in bathroom #1 at 117.3 degrees F and bathroom #2 at 119.9 degrees F which is within the required105 -120 degrees F.

Section 80075(k)(1) Health-Related Services - medication cabinet located in kitchen was observed unlocked during the visit. On 3/1/22 LPA Flores observed cabinet locked during the visit.

Deficiencies have been cleared during this visit.

Exit interview was conducted with Kimberly Isaac Assistant Administrator and a copy of this report was provided.

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