Facility Evaluation Report

Licensing Program Analyst (LPA) N. Galarza arrived at the facility unannounced for the purpose of conducting the Required 1-Year annual evaluation. LPA was greeted and granted entry by caregiver staff Antonio Santiago. Facility Designee Andrew Escobar arrived shortly after. Administrator has a valid administrator's certificate expiring on 7/26/2027.

The following was observed during the inspection:

Infection Control: The facility has an Infection Control Plan.

Operational Requirements: A Dementia and hospice waiver for 3 residents has been approved. A fire clearance for 5 non-ambulatory and 1 bedridden in room #3. The facility does not handle resident P & I monies. Liability Insurance in the amount of at least ($1,000,000) per occurrence and ($3,000,000) in total annual aggregate is current with an expiration date of 9/11/2026.

Physical Plant/Environment Safety: The interior and exterior physical plant was inspected. The facility is a single-story home located in a residential area consisting of three (3) shared resident bedrooms, one (1) live-in staff room, two (2) bathrooms, kitchen, dining room, living room,and laundry area in attached 2-car garage currently used as storage. The backyard has an covered patio and storage shed in the rear of the backyard. The front and backyards are landscaped with grass. Required furniture, bed mattress pads, and linens were observed. Cleaning supplies and toxic substances are inaccessible to residents. The facility has two fire extinguishers. Water temperature readings measured within the required 105 - 120 degrees Fahrenheit. Electrical smoke and carbon monoxide detectors were tested and are operational. The home has central heating & air conditioning. Comfortable temperature for residents is maintained. Exit doors are free of any obstruction and there are no pools. No record of Emergency Disaster drill was provided. A citation was issued.