Facility Evaluation Report

Licensing Program Analyst (LPA) Jessica Cho arrived unannounced for the purpose of conducting the Required 1-Year annual evaluation using the Care Inspection Tool. LPA was greeted and granted entry by Caregiver Eric Fonseca and explained the reason for the visit. Approximately 10:15am, Administrator Harris Mendoza arrived. Administrator Daniel Rescia has a valid administrator's certificate expiring on December 13, 2025.

The facility is a single story structure and is licensed to operate for six non-ambulatory residents, in which one may be bedridden. Facility maintains a hospice waiver for four residents. There are five residents in care with one resident under hospice and two caregivers on duty. There are five resident bedrooms and three resident bathrooms. There are two staff private bedrooms. All common areas were inspected including the the attached two car garage. The residents' bedrooms were appropriately furnished. Beds and bedding supplies were in good condition, adequate lighting was provided, sufficient storage space for each residents' personal belongings were observed. Bathrooms were found to be in compliance, clean, and operational. The hot water temperature measured at 107.7, 107.0, and 118.7 degrees Fahrenheit. Toxins, disinfectants, sharps, and medications were secured and inaccessible. LPA observed sufficient two-day supply of perishables and seven-day supply of non-perishable food available. The fireplace was properly screened. LPA toured the exterior portion of the facility. The outdoor passageway is free of obstruction. One out of the two exit gates were not self-closing and self-latching. LPA observed sufficient seating and shading. The fire extinguisher was charged, mounted, and serviced on June 18, 2024. The auditory devices and smoke/carbon monoxide detectors were tested and operational, however the volume for one smoke detector in one resident's bedroom was not as audible in comparison to remaining smoke detectors. LPA observed sufficient emergency food/water/generator in the garage. Emergency evacuation drills are conducted quarterly. The first aid kit contains all necessary elements. The facility land line number, (714) 632-5813, was tested and remains available. The liability insurance is valid expiring on November 20, 2025. The 'See Something, Say Something' (PUB 475) poster was observed in the correct size in the entry way.