Facility Evaluation Report

Licensing Program Analyst (LPA) Hanna Gough arrived at the facility to conduct the required annual inspection. LPA was greeted and granted entry by staff. LPA met with Administrator Roy Santa Ana and explained the purpose of the visit. The facility currently has five residents in care.

The facility is a one story home with five resident bedrooms, two resident bathrooms, staff bedroom, staff bathroom, office, kitchen, living room, laundry room and backyard. The facility appears clean, safe and sanitary. LPA observed all the required departmental postings throughout the facility. LPA observed the kitchen to be clean and free of vermin. LPA observed a two day perishable and seven day non-perishable food supply on hand. LPA observed the toxins and chemicals to be locked and located under the kitchen sink and in a locked cabinet in the laundry room and made inaccessible to residents in care. LPA observed the sharps to be in a locked drawer by the kitchen sink and made inaccessible to residents in care. LPA observed a fire extinguisher located in the kitchen charged and with a service date of May 24, 2025. LPA observed resident bedrooms to have all the required components and furnishings. LPA observed resident bathrooms to have toilet paper, paper towels and non-slip mats. LPA tested the water to be 105.9 degrees Fahrenheit. LPA observed the centrally stored medication to be in a locked closet located by the front door. LPA observed an extra supply of clean linens in a cabinet located in the hallway. LPA observed the staff bedrooms and office to be locked and made inaccessible to residents in care. LPA observed the emergency food and water supply to be located in the office. LPA observed the backyard is free of obstructions and has a shaded seating area for resident use. LPA observed the three sheds in the backyard to be locked and used for extra storage. Administrator tested the fire and carbon monoxide detectors and LPA found them to be operational.