Facility Evaluation Report

On 4/3/24 Licensing Program Analysts (LPA’s) Alfonso Iniguez and Wendy Gibbs conducted a pre-licensing evaluation for an RCFE facility type. Today’s pre-licensing evaluation was conducted with authorized licensee: Desiree Kitagawa/Administrator.

The licensee has applied for a license to serve (121) elderly residents age range 60 and over. The fire clearance is approved for (101) non-ambulatory and (20) bedridden where twenty (20) can be bedridden on first floor #116-120, 123-127, 135-137 and 147. Basement and second floor for non-ambulatories only. Approved hospice waiver for (15).

A tour of the entire facility was conducted: basement floor, first floor, second floor, kitchen, common areas, outside of facility, medication room, records room, generator bathrooms, activity program, weekly menus.

The following was observed during this visit:

There is a locked centralized storage area for Resident medications.

Facility is clean, sanitary, and in good repair. Protective devices are in place. Indoor and outdoor passageways, stairways, open porches, and other areas of potential hazard are free of obstructions. All window screens are clean and in good repair. Facility temperature is between 68°F. degrees and 73°F. degrees. Open porches, and areas of potential hazard are well-lit. Smoke alarms operate properly. Carbon monoxide detectors operate properly.