Facility Evaluation Report

Licensing Program Analysts (LPA) Jerome Haley conducted an unannounced visit to the facility to complete the required Annual inspection. LPA Haley met with Licensee/Administrator Stella Ladaban and toured the facility.

The facility has a capacity of 6, of which 5 can be non-ambulatory and 1 may be bedridden. The facility phone number 714.484.1493.

Structure : The facility is one level structure with six bedrooms. Currently three bedrooms are being occupied by residents and 1 bedroom is being occupied by staff.

Kitchen: Clean and organized. Sharps locked in a drawer. A perishable food supply was observed in the refrigerator and freezer. Non-perishable food supply was observed in the cabinets and in the pantry near the front door across from the kitchen.

Stove/Appliances: There’s one stove with 4 burners and a warmer, a refrigerator, dishwasher, washer, and dryer. All appliances are clean. The top left burner on the stove does not light unassisted. The washer machine in the garage is not currently working.

Toxins: All cleaning supplies and chemicals are locked under the kitchen sink.

Medications, First-Aid Kit: Resident medications are locked in a close next to the front door. In the locked medication closet, a first aid kit with all the required elements was observed.

Resident & Staff Files : The Resident and Staff Records are kept locked in the closet next to the front door with the medications and the first aid kit.

Bedrooms: Resident bedrooms were clean, organized and were in compliance with regulation guidelines.

Bathrooms: The bathroom has a working toilet, wash basin and shower. Grab bars were tightly secured to the wall.

Hot Water : Hot water was measured at 110.1 degrees F.