Facility Evaluation Report

License Program Analyst (LPA) Hansen arrived unannounced to conduct an annual required - 1 yr. visit of the facility. LPA was welcomed by staff, Maria Sanchez. Viridiana Agapoff, Administrator was contacted by staff and arrived during the visit. There is a total of 7 residents, all with a diagnostic of dementia. There is 4 residents currently on Hospice.

LPA toured the facility on 12/18/2023 at 9:00 AM; facility was found to be clean and at a comfortable temperature with all exits free from obstruction. The facility serves residents with dementia and has a plan of operation for special care and programming. All bedrooms have lighting & appropriate furnishings. There was a sufficient supply of both perishable and nonperishable food as required by Title 22 Regulations. Food stored in the kitchen refrigerator were properly stored as per regulations on this day at the time of the visit. Toxins are stored in a locked cabinet in the laundry area. Hot water temperature measured between 130.8 degrees F and 135.5 degrees F, falling out of Title 22 acceptable regulation of 105 to 120 degrees F in 3 of 3 resident’s bathrooms while touring facility on 12/18/2023 at 9:30am. Administrator turned hot water heater down on the 1 (out of 2 hot water heaters at facility) regulating residents bathrooms (see LIC809-D). The bathrooms designated for residents at the facility were supplied with individual paper towels and hand soap dispensers. Bathrooms were equipped with necessary grab bars, and non-slip floors/mats were present in the bathroom shower. Fire Extinguisher was found to be last charged on 12/23/2022 at the time of the visit. Facility has fire sprinklers throughout. Smoke detectors and carbon monoxide detectors were found to be operational during the visit.

A review of 7 residents & 5 staff records as well as two resident’s medications was conducted during this visit. LPA reviewed resident’s files at 10:30 AM on 12/18/2023 and learned that 3 of 7 residents do not have an updated re-appraisals/needs & care plans and or updated physician’s assessments (LIC 602A) on file (see LIC809-D).