Facility Evaluation Report

On 06/19/2024 at 9:00 am Licensing Program Analyst (LPA) David España conducted an unannounced Required-1-year annual visit. Upon arrival at the facility, LPA España conducted a risk assessment at the front door. Based on the assessment, the facility is clear of COVID-19 infection. LPA verified that the facility has an approved mitigation plan report. LPA was granted access and allowed to enter the facility to conduct the inspection. The facility is licensed for a Residential Care for the Elderly. The capacity is for 6 residents, 6 non-ambulatory, 0 bedridden. Facility has a dementia care plan in place. LPA was greeted and accompanied on inspection by Paige Esquivel, House Manager. LPA toured the physical plant, inspected food service, reviewed staff records, and reviewed resident files for medical status. There are 1 receiving Home Health and 2 receiving Hospice Services. Facility has 5 client bedrooms, 5 client bathrooms, living room, dining room and kitchen. Facility is a single-story house. The client bedrooms are spacious and will easily accommodate the client's furnishings. There is a shaded side yard with an umbrella, table and chairs. Outdoor passageways, walkways, driveways, steps and patios are free from obstructions. LPA did not observe hazards, such as ladders, gardening tools and/or motorized equipment in the front, back and/or side areas of the facility. Continued on 809-C