Facility Evaluation Report

On this day Licensing Program Analyst (LPA) Fred Arias made an unannounced visit to conduct a required annual visit. LPA was greeted and granted entry into the facility by staff and explained the reason for the visit. Facility is licensed for 15 non-ambulatory residents. Facility has an approved hospice waiver for 15 residents and the home currently has 10 residents, with 2 residents on hospice. Administrator (AD) Aurora Tecson arrived shortly to help conduct facility visit. AD provided updated liability insurance that expires on 07/06/2025.

LPA along with staff toured the facility at 12:10 PM. LPA toured the physical plant, checked food service, and facility documentation. The home consists of 8 resident bedrooms, living room, dining room, and kitchen as well as 2 bathrooms on the first floor. The second floor consists of an office and two staff rooms. No residents in care are in the second floor. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. LPA observed all resident beds had bed rails. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure and shower was free of mold/mildew. Water temperature measured between 119.3 degrees F and 119.8 degrees F in all bathrooms. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards. Auditory exit alarms were operational during today's visit. LPAs toured the kitchen and observed sharps locked in a cabinet during today's visit. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. Kitchen appliances were operational during today's visit. Fire extinguishers were fully charged. LPA reviewed the infection control and emergency disaster plans and plans are complete and thorough.