Facility Evaluation Report

Licensing Program Analyst (LPA) Vadim Gorban arrived unannounced for an Annual Required Inspection. LPA met with Administrator Christina Pelayo, stated the purpose of the visit and was allowed entry. A tour of the facility was conducted. Facility has one entrance/exit point.

Facility tour was conducted. Facility appeared clean with no obstruction or fire clearance issues. Fire extinguisher service date on November 14th, 2024. Last fire drill recorded on 5/01/2025

Hand sanitizer was readily available to residents and visitors. Bathrooms have trash cans with lid. Hand washing posters were observed by the bathrooms. Bedrooms were checked. The exterior tour was conducted.

Dining area and Kitchen were toured. An adequate supply of perishable and non-perishable food was observed to be properly stored in freezer, refrigerator, and pantry. Refrigerator temperature was maintained at 39.0-degree F. and freezer was maintained at -2-degree F.

LPA checked residents’ medication records. Food supply was checked and there appeared to be an adequate supply. Cleaning supplies were checked. Staff records were reviewed for good health and infection control training. Facility staff was observed communicating with resident in polite manner. LPA observed residents after lunch in common area.

Resident’s files have updated emergency contact information.

Facility operational phone number 209-664-1378

Exit interview was conducted, report signed and provided to administrator for facility records.