Facility Evaluation Report
Licensing Program Analyst (LPA) Mary Flores conducted an unannounced annual visit at the facility using the CARE inspection tool. LPA met with Gliceria Mabuti and explained the reason for the visit.
The facility is licensed to serve 6 residents over the age of 60 years old, of which 6 may be bedridden, with a hospice waiver for 3. Facility currently is serving (3) residents on hospice. Facility is located in a residential area and consist of a single home with 6 bedrooms and 3 bathrooms, a dining room, a living, room, a family room, a kitchen, a front yard, and back yard.
LPA Flores conducted a tour with Jaizel Mabuti - Caregiver and observed the following:
Facility is in good repair inside and outside. Kitchen was observed clean and sufficient food for at least 2 days of perishables and 7 days of non-perishables were observed. Medication and sharps were observed locked in kitchen cabinets. Laundry area is clean and cleaning supplies were observed locked. Five (5) Resident rooms were observed with sufficient lighting, the required furniture and bedding supplies. Half bed rails were observed on room #5 and #6 and full bed rails were observed on room #3 in resident's beds. Room #4 was not observed as it is currently being used as a staff room. Three (3) Bathrooms were observed clean and in good repair. Bathroom #3 in room #6 was observed without a skid mat/strips. Water temperature was tested in each bathroom and tested between 115.5 - 117.8 degrees F., which is within the required 105-120 degrees F. Facility has a sound devices in each exit door which are in working condition. Smoke/Carbon monoxide detectors were tested and are in working condition, detector in room #3 had a faint noise. Fire extinguisher was observed by the kitchen and was last checked on 12/9/23. Backyard and front yard are clean and have a seating area. PUB 475 or Local Ombudsman posters were posted behind the entry door at the facility.
LPA reviewed medication for 2 residents, and files for 3 residents. (CONTINUED ON LIC 809C)
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction