Facility Evaluation Report, 10/19/2023 — Bello Gardens Assisted Living, San Anselmo CA

License Program Analyst (LPA’s) Hansen and Rummonds arrived unannounced to conduct an Annual Required – 1 yr. visit of the facility. LPA’s had caregiver Josefa Mancinas contact Administrator who arrived during the inspection. There is a total of 22 residents. There is 2 residents currently on Hospice and some residents with Dementia.

LPA’s entered the facility with auditory alarm going off and waited in entrance room for approximately 7 minutes observing other residents walking the halls and then went to find care staff, all of which were in dining area (see LIC809-D) LPA’s toured the facility on 10/19/2023 at 9:15 AM with Josefa Mancinas; facility was found to be clean and at a comfortable temperature with all exits free from obstruction. Fire Extinguisher was found to be last charged on 6/29/2023 at the time of the visit. Facility smoke detectors were tested and found to be operational at the time of the visit. Smoke detectors and fire sprinklers are inspected, and inspection records are current with the last inspection being conducted on 10/5/2023 . LPAs observed Carbon monoxide detectors that were found to be operational during the visit. There is a backup generator that powers many of the fixtures in the common areas of the facility that come on should a power outage occur. Hot water temperature measured between 110.4 degrees F and 100.4 degrees F. falling out of Title 22 acceptable regulation of 105 to 120 degrees F in 6 of 9 resident’s bathrooms while touring facility on 10/19/2023 at 10:25AM (see LIC809-D).

Facility serves residents with dementia and has special care plan of operation and programming. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. Food stored in the kitchen refrigerator were properly stored as per regulations at the time of the visit. LPAs toured the kitchen area on 10/19/2023 at 10:00 AM; although toxins were observed stored with food in kitchen (see LIC809-D). Food is available for residents any time of the day. There is a daily activity schedule for residents.