Facility Evaluation Report

On 08/10/24 at 9:10 AM, Licensing Program Analyst (LPA) Regina Cloyd conducted an unannounced required – annual inspection and met with Licensee Vicenta Mendoza.

This facility is licensed to serve 6 adults ages 60 and above, of which 4 may be non-ambulatory residents. Facility must maintain a 24-hour awake staff. Facility is approved for 6 hospice residents. The facility currently has one resident on hospice.

The facility is a one-story house located on a residential street. The home consists of 3 resident bedrooms, 1 staff bedroom, 2 bathrooms, 1 dining/living room, 1 kitchen, 1 attached garage, and a front yard and backyard patio area with shaded seating.

The Licensee accompanied LPA inside and outside the facility during this inspection. Outside grounds were toured and no bodies of water were observed.

Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. There are no weapons on the premises.

Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure, shower was free of mold/mildew and a non-skid mat was in place, and hot water temperature properly measured at 109.2 degree F. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Continue to LIC809-C.