Facility Evaluation Report

Licensing Program Analyst (LPA) Sarah Hurt conducted an unannounced visit today for the facility’s annual inspection. LPA met with facility staff, Facility staff, Flordeliza Bulosan, Continual Administrator's Certification for Mila Green expires 12/2027. There are currently 4 residents who reside at this home. LPA inspected the interior and the exterior of the facility including the common living spaces, resident bedrooms and bathrooms, activity rooms, medication storage, kitchen, garage and outdoor areas.

Fire extinguisher is within the safety regulation period. Toxins and cleaning supplies are locked and inaccessible.

LPA observed dust on the window sill, broken stove knob, light fixtures with no covers, and dining table chair very dirty and ripped. LPA observed the facility dryer in disrepair. LPA observed the facility does not have required 2 day perishable food supply. LPA observed locks on both backyard fence gates. LPA observed a sign on medication cabinet that reads " If Resident 1 is acting up call Staff 1 immediately."

The following deficiencies observed or cited during today's inspection per California Code of Regulations, Title 22.

LPA requested the following documents: LIC 500 Personnel Report, LIC 308 Designation of Administrative Responsibility, LIC 610-E the Emergency Disaster Plan and copy of current Administrator’s Certificate to update the facility file. Listed documents shall be sent to Licensing.

Exit interview conducted with Facility staff, Flordeliza Bulosan, and copy of report left at facility