Facility Evaluation Report

Licensing Program Analyst (LPA) William Vanegas made an unannounced inspection for the purposes of conducting an annual inspection. Upon arrival LPA Vanegas was greeted and granted entry by Care Giver (CG) Martin Jose. LPA Vanegas began to set up equipment, began a tour of the facility, and observed the following.

This is a one storied home with four bedrooms, two bathrooms, and a one car detached garage. LPA Vanegas observed the kitchen area to be clean and free of any mildew. LPA Vanegas observed a refrigerator, microwave, dishwasher, gas stove, washer, and dryer. All appliances appeared to be in good repair, and tested to be operational. LPA Vanegas observed a two day supply of perishable food, and a seven day supply of non-perishable food, along with a sufficient amount of emergency water.

LPA Vanegas observed all resident rooms to be clean and free of any debris. LPA Vanegas observed the bedrooms to have all required furnishings such as a bed, clean linens in good repair; meaning no strains or tares, chest drawer, a reading lamp, and enough storage space to store personal belongings.

LPA Vanegas observed resident bathrooms to have all required furnishings such as grab bars, shower chair, and slip resistant floor matts. LPA Vanegas observed bathroom water faucets and toilets to be operational, and in good repair. Water tested between 119.8 and 125.3 degrees. LPA Vanegas observed all fire extinguishers to be fully charged and up to date. LPA Vanegas observed all smoke detectors and carbon monoxide detectors to be in good repair and operational.