Facility Evaluation Report

Licensing Program Analyst (LPA) Jeremiah Randle conducted an unannounced Annual required and infection control visit to the above facility. LPA was met by Licensee TERESITA CASTANEDA and the purpose of today’s visit was explained.

There are currently (3) residents in the facility. (1) residents are ambulatory, (2) are non-ambulatory, (0) bedridden. The facility is a single-story structure located in a residential neighborhood. It consists (6) bedrooms, (2) full bathrooms for residents, shaded back yard, front yard, laundry room and detached 2 garage.

LPA and Licensee toured the entire facility inside and out. Documents are posted as mandated. Bedrooms 1,2, and 4, are occupied by residents bedrooms 3 is vacant, bedroom 6 if for staff, all contain the mandated furniture. The (2) bathrooms have grab bars and non-skid mats and are clean and operational. First aid kit is fully stocked with manual; smoke detectors and carbon monoxide detector were in compliance and operational. No firearms are stored at facility and no bodies of water present. Medications are stored, locked and inaccessible to residents. (1) Resident file along with medications are current. (1) Staff file is current. Ample supply of perishable and nonperishable food, hot water temperature is within title 22 limits, linens and personal hygiene supplies are adequate, hazardous toxins and/or sharp items are inaccessible to residents, (1) fire extinguishers is fully charged.