Facility Evaluation Report

Licensing Program Analyst (LPA) Elizabeth Irra conducted a scheduled pre-licensing visit. LPA met with Rocio Collado (Applicant/Administrator), Anna Aldiano (Assistant Administrator) and Lucio Collado.

This facility consists of (6) bedrooms, (1) staff/employee room, (3) full bathrooms, (1) ½ bathroom, utility room (laundry), living room, dining room, kitchen. This facility is approved for (12) AMBULATORY residents only. During this visit, LPA conducted a facility tour and conducted Component III.

Carbon monoxide detector was tested and operable.

Fire extinguishers located in the kitchen and near the dining room.

Cleaning solutions (under kitchen sink) and sharps are locked in the kitchen.

Building and grounds are free from hazards.

Bedrooms are large enough to allow for easy passage between and comfortable for usage of beds and other required items of furniture.

There are enough bath towels, hand towels and wash cloths for all residents.

There are sufficient amount of linens available to permit weekly changing to ensure use of clean linens at all times by residents.

Facility has a washer and dryer that are fully operational located inside the utility room.

Pantry's cupboards, freezers, stoves, microwaves, refrigerator and counters are clean.

Two-day supply of perishables available, seven day supply of non-perishable available.

Pesticides and other toxic substances are stored and locked away from food supply.

Staff and Resident files (including resident medications) will be locked inside the staff/employee room.

Refer to LIC 809C for the continuation of this report.