Facility Evaluation Report, 06/22/2022 — Noumea Care Home III, Buena Park CA

Licensing Program Analyst (LPA) Jerome Haley conducted an unannounced visit for the purpose of conducting a required one year infection control annual visit. LPA was greeted, granted entry by staff and explained the reason for the visit. Staff called the Assistant Administrator (AD) Karen Saturno who arrived and was present for the visit. AD Saturno has a current administrators certificate that expires 11/7/24.

At 1:08 pm LPA Haley began the tour of the facility with AD Saturno. There were three clients present for the visit. All client bedrooms were clean, well organized, and had all necessary requirements: night stand, chair, lamp and storage space. Both client bathrooms were clean and organized. Hot water temperature was measured at 108.1 degrees Fahrenheit in client bathroom #1 and 106.7 degrees Fahrenheit in client bathroom #2.

The kitchen was clean and organized. All knives and sharp objects were locked under the stove. All burners on the stove were operational. The facility has a two day supply of perishable food items and seven day supply of nonperishable food items

The garage was clean and organized. All hazardous chemical are locked in a cabinet in the garage. There was also an additional food and water supply stored in the garage.The backyard was clean, organized, and free of clutter. There was a side exit gate that was self closing and self latching. In the backyard, LPA Haley observed a shaded area with a table and chairs.

In the living room LPA Haley observed a locked medication cabinet, a temperature thermometer for screening clients and visitors and a screening log book. The facility has adequate PPE supply of gloves, N95 mask, face shields, and hand sanitizers. Further, LPA Haley observed emergency kits prepared and ready to go.

There were no bodies of water observed. All smoke detectors were tested and are operational. No deficiencies are being cited during todays visit. An exit interview conducted and a copy of the report was provided to the Administrator Karen Saturno.