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 Raymond Tinio and toured the facility.

The facility has a capacity of 6, of which 6 can be non-ambulatory and 1 may be bedridden. The facility has a Hospice waiver for 6. The facility telephone number 714.723.0169.

Structure : The facility is one level structure with four bedrooms. Currently one bedroom is vacant and one bedroom is being shared by a husband and wife.

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.

Stove/Appliances: There’s one stove with 4 burners and a warmer, a refrigerator, dishwasher, washer, and dryer. All appliances are clean and operational.

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

Medications, First-Aid Kit: Resident medications are stored in a locked cabinet in the kitchen. There’s a first aid kit with all the required elements on a stand right below the sign in book as soon as you walk in the front door.

Resident & Staff Files : The Resident and Staff Records are kept locked in a desk drawer in the office area in between the living room and kitchen areas.

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

Bathrooms: There are two bathrooms and both bathrooms have a working toilets, wash basin and shower. Grab bars were tightly secured to the wall.

Hot Water : Hot water was measured in the range of 105 - 107.1 degrees F.