Facility Evaluation Report

At 11:00am on 1128/2023, Licensing Program Analysts (LPAs) Huma Rahimi, and Leslie Ngo-Castaneda conducted an unannounced annual visit. LPAs met with staff Miriam Mendoza and was advised the reason for the visit. LPAs advised staff to please contact administrator, Jill Mateo arrived at 11:50 and was disclosed the reason for the visit. LPAs and assistant administrator began to tour the facility at 11:55am.

The facility is a single story building with six(6) bedrooms, two (2) bathrooms, kitchen, common areas, and outdoor areas. It has an approved fire clearance for four (4) ambulatory residents.

Medications: At approximately, 11:30 am LPAs observed medications are centrally stored and locked next to the kitchen in a separate cabinet.

Kitchen : At 11:58 am LPAs observed an adequate supply of perishable and non-perishable food in the kitchen. The facility has two (2) refrigerators. The stove hood was clean. All appliances and surfaces were sanitary and functional. Sharps were locked above the counter top, and cleaning solutions were locked under the sink.

Bedrooms : At 12:05 pm LPAs toured the bedrooms and observed that there are six (6) bedrooms. Room #1 is a private room that is located in the hallway and room #4 is for private use that is located by the dining room area. Room #2 is shared that is located at the end of the hallway. Bedroom #3 (three) is for live-in staff that is located by the entrance of the facility. Room # five (5) is used as an office and room # six (6) is used for staff bedroom as well that is located by the common area. The assistant administrator noted that the staff rooms and office are always locked. All bedrooms contained a chair, night-stand, lamp, flashlight, storage, and bed with adequate bedding. The facility walls, floors, ceilings, windows, screens, and curtains were clean and in good repair.