Facility Evaluation Report

At approximately 10:10 AM, Licensing Program Analyst (LPA) Shannan Hansen arrived unannounced to conduct a required 1-year annual inspection and was greeted by Staff. Administrator, Frank Nola, was contacted and arrived at approximately 11:00 AM. Facility is a Residential Care Facility for the Elderly (RCFE) with 23 residents in care. Facility has a Dementia Care Plan, is approved by San Anselmo Fire District for 14 ambulatory & 11 non-ambulatory residents, bedridden residents on first floor only, and has a Hospice waiver for 5. Facility currently has three (3) Hospice resident in care.

At approximately 10:20 AM, LPA initiated a tour of the facility with Staff Walter and observed the following: Facility is a two story converted convent, was a comfortable temperature, and passageways were free from obstructions. LPA observed an evacuation chair at each stairwell for emergency prepairdness. Water temperatures in 6 of 6 residents' bathrooms/communal bathrooms measured, within the allowable range of 105 to 120 degrees F per Title 22 regulations. LPA observed a supply of clean linens, and hygiene, incontinent care, and paper products available for residents. Residents' bedrooms were inspected and observed to have all the appropriate furnishings as outlined in Title 22 regulations. Cabinets containing cleaning supplies and other items that could pose a risk were locked. LPA observed menu posted throughout the facility, and facility has at least two days of perishable food and one week of non-perishable foods, as well as an emergency Food and water supply. Medications were centrally stored and locked in two med carts. There is a shaded seating area in the backyard with outdoor space for activities. LPA observed two (2) locked sheds in backyard which LPA inspected and observed the contents to consist of PPE supplies, extra resident care equipment, holiday decorations, chemicals and tools.