Facility Evaluation Report

Licensing Program Analyst (LPA) Tao conducted an unannounced annual visit at the facility using the CARE inspection tool. LPA met with Administrator assistant Laura Marcela Aguillar and explained the reason for the visit.

The facility is licensed to serve six (6) non ambulatory residents who are ages 60 and above. The facility is a single-story home located in a residential area in Pasadena. The facility consisted of a living area, dining room, kitchen, five (5) resident bedrooms, three (3) bathrooms, office area, laundry room, detached garage, front yard and back yard. Annual fees are current.

The following CARE tool domains were reviewed during this visit:

Infection Control: Sufficient PPE supplies and an Infection Control Plan maintained at the facility were observed and in compliance.

Physical Plant & Environment Safety: Physical plant tour was conducted. Residents’ bedrooms were checked and closet/drawer space to accommodate each resident comfortably was available. The backyard, outdoor and passageways were free of obstruction and debris/hazards. Hygiene products were readily available for residents. All storage areas for cleaning solutions, toxins, knives, and hazardous items were kept in a locked cabinet and were inaccessible to residents. Water temperature was tested and the temperatures were between 113 – 115.4 degrees F., which is in compliance with regulations. A pool was secured with a 5ft fence. Auditory devices were operable. (-Continued on the LIC809-C)