Facility Evaluation Report

On 8/2/2022, Licensing Program Analyst (LPA) Lourdes Montoya conducted an unannounced annual required visit with a primary focus on Infection Control measures using the new CARE Inspection Tool. Upon arrival at the facility, LPA Montoya called the facility, spoke with House Manager (HM) Barbara Papilla and conducted a risk assessment. Based on the assessment, the facility is clear of Covid-19 infection. The designee, Minda Mcnamara, arrived later and joined the visit.

The facility is licensed for six (6) non-ambulatory residents, of which one (1) may be bedridden and an approved hospice waiver for three (3) residents. Currently, the facility has six (6) residents of which three (3) are hospice residents.

The facility is a single-story structure located in a residential neighborhood. It consists of the following: five (5) resident bedrooms, living area, dining area, kitchen, and outside covered patio area.

LPA Montoya toured the inside and outside grounds of the facility with HM Papilla. There were no bodies of water or obstructions on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for resident personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. Bathrooms were found to be within Title 22 regulations and were clean and operational. The water temperature measured 116.2 degree F. A comfortable temperature of 79 degree F. was maintained in the facility.

LPA observed the facility to be sanitary and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and not accessible to residents. The kitchen was inspected and there is sufficient perishable and non-perishable food available maintained properly. The facility has (2) fire extinguishers that were charged, smoke detectors, and carbon monoxide were operable. The facility conducted a Fire/Safety Drill on 6/10/2022. A working telephone (310)530-7104 remains available.