Facility Evaluation Report

On today's date LPA William Vanegas conducted an unannounced visit for the purposes of completing an annual inspection. Upon arrival LPA Vanegas was greeted and granted entry to the facility by Care Giver (CG) Estela De Venecia. LPA William Vanegas explained the purpose of the visit and began a tour of the facility and observed the following.

LPA Vanegas observed the facility to be a one storied building with five bedrooms all five bedrooms are used for residents in care. The facility has two bathrooms that are used for residents in care, and has one shared bathroom for resident and guests. The facility has an attached two car garage, and a large backyard. LPA Vanegas observed the kitchen area to be clean and sanitary. LPA Vanegas observed a gas stove, refrigerator, dishwasher, and microwave in the kitchen area and all tested operational. LPA Vanegas observed a two day supply of perishable food and a seven day supply of non-perishable food and a sufficient amount of water on hand and available to residents in care and staff in case of an emergency.

LPA Vanegas observed resident bedrooms to be clean and sanitary. Bedrooms were observed to have all required furnishings such as a chest drawer, bed, clean linens in good repair; meaning no strains or tears, a closet for storage of personal items, as well as a reading lamp. LPA Vanegas observed rooms to be large enough to walk about freely, and no obstructions blocking the doors or entry ways. LPA Vanegas observed all required posters displayed along the entry way and hallways including PUB475 sign and residents rights posted.

LPA Vanegas observed all resident restrooms to be clean and free of any mildew and debris. LPA Vanegas observed water faucets, and toilets to be operable and bathroom shower had grab bars, and slip resistant floors. Water temperature tested between 106.7 and 108.8 degrees.