Facility Evaluation Report

At approximately 9:15AM, Licensing Program Analyst (LPA) Felias arrived unannounced to conduct an Annual Continuation Visit and met with Executive Director/Administrator, Corrine Tanchoco. Upon arrival, LPA was informed that there were currently 69 Residents in care.

At approximately 9:40AM, LPA reviewed a sample size of 6 staff files and 6 Resident Files. Resident and Staff files were all found to be well organized, thorough and contained the required documentation. Administrator's Certificate (6003554740) was current with an expiration date of 02/26/2024.

At approximately 12:30PM, LPA conducted a walk through of the facility. A sample size of 8 sinks were tested. LPA found that hot water temperatures were within Title 22 regulations of 105 to 120 degrees Fahrenheit.

At approximately 1:00PM, LPA reviewed a sample size of 6 Resident medication records. Medication was observed to be centrally stored and secure. At approximately 3:00PM, LPA conducted staff and resident interviews.

LPA unable to complete the Annual Inspection. Annual Continuation Visit to be conducted at a later date.

Exit interview conducted. Copy of report discussed and provided to Administrator. Signature on form confirms receipt of documents.