Facility Evaluation Report

Licensing Program Analyst (LPA) Blanca Gonzalez conducted an unannounced required annual visit. LPA was greeted by staff and the purpose of the visit was explained. Manager Rathany Suy arrived to assist with the tour.

The facility is licensed to serve age range 60 and over, six (6) non-ambulatory residents of which one (1) may be bedridden. Approved hospice waiver for two (2) residents.

The facility is a single story home located in a residential area of San Dimas. The home consists of five (5) bedrooms, two (2) bathrooms, kitchen, dining area, living room, backyard and an attached garage.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following:

Facility has an Infection Control Policy in place and was observed to be posted.

The front and backyard are well maintained and there are no pools or large bodies of water. There is a shaded area located in the backyard with sufficient seating for residents in care. Passageways and exits are free of obstruction.

The water temperature was tested in bathrooms and one bathroom measured 106.7°F which is within the required 105° F - 120° F. The second bathroom measured 103.6°F, technical violation was issued. LPA observed grab bars and non-skid mats in both the bathrooms.