Facility Evaluation Report

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of conducting a case management visit regarding deficiencies observed during the investigation of complaint #22-AS-20230301140104. LPA was greeted and granted entry by caregiving staff. Administrator Leilani Alejandro arrived later to assist with the visit.

LPA accompanied by caregiver conducted a tour of the physical plant and observed the following: Upon arriving at the facility, LPA attempted to use the doorbell, which was found to not be functional. LPA resorted to knock, which facility staff did not immediately hear either. An Technical Assistance Advisory Note to that extent is being issued.

The mounted fire extinguisher observed on the kitchen wall shows a maintenance tag for a revision conducted in July 2021, which means the maintenance update need to be done by the end of the month of July 2022. Due to a misunderstanding, the vendor contracted by the licensee changed the extinguishers at one location operated by the licensee but not at State Royale Guest Home.

A type B deficiency is being cited per Title 22 of the California Code of Regulations.

An exit interview was conducted and a copy of this report along with appeal rights was provided and left at the facility.