Facility Evaluation Report

Licensing Program Analyst (LPA) Araceli Canela conducted an unannounced Annual Required – 1 yr. inspection to this facility and met with Administrator Kam Gantan. Facility is licensed for 24 residents and it is at full capacity at the moment. Administrator provided LPA with a copy of an approved Hospice Waiver for 6 and LPA will update the facility license. Facility offers activities including exercise, music therapy, art and Bingo.

During facility tour, facility was found to be clean and at a comfortable temperature with all exits free from obstruction. Resident’s bedrooms, common areas, kitchen & food storage areas were inspected. Fire Extinguisher was last inspected on 4/10/2023. Disaster Drills and Emergency Disaster Plan were conducted and last one documented on 9/1/2023. Fire panel was inspected on 9/6/2023.

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. Dangerous items were stored inaccessible to residents. There was a supply of hygiene products and paper products available for residents. Resident bedrooms had most of the required furnishings and some resident rooms were missing a lamp. Hot water temperatures measured between 105 degrees and 120 degrees F within Title 22 acceptable range.

Staff and resident files were reviewed. Staff have the required training and proof of CPR/1st Aid, expiring 9/2024. Medications are locked in medication cabinet and staff and resident files are in the facility office.