Facility Evaluation Report

Licensing Program Analyst (LPA) Noemi Galarza made unannounced case management visit regarding a self reported incident on the relocation of 2 residents from El Molino Manor # 197609014 to Rosemead Villa due to mandatory evacuation orders from Fire Advisory. LPA met with Assistant Administrator Zosimo Pascasio Jr and explained the purpose of the visit. A physical plant tour of the facility was conducted to check the health and safety of the 2 evacuee residents.

Both relocated residents have designated rooms with beds, bedding/linen, and hygiene supplies. Residents are in need of more clothing. Residents do not use medical equipment and are ambulatory.

Medication Administration Records (MARs) and resident file documents were reviewed. Residents were transferred without file documents because all documents burned during the fire. Both facilities are under the same Licensee and new file documents have been created/obtained.

No additional staff were needed in order to accommodate the increase in resident census. A total of 6 caregivers are presently employed.

The facility did not provide a staff roster and/or LIC 500 Personnel Report. A technical violation was issued.

The facility has sufficient 2-day perishable and 7-day non perishable food supplies. The facility dining room is able to accommodate all residents.

The last 5-year fire inspection was conducted by State of California State Fire Marshall on 9/19/2022. The last fire drill was conducted on 1/3/2025.

Administrator stated that both resident (R1's) responsible party was notified of relocation. Resident (R2) does not have family and/or a responsible party.

Exit interview was conducted with Assistant Administrator Zosimo Pascasio Jr. A copy of the report was issued.