Senior Care Records.

Facility Evaluation Report

Noumea Care Home II, Cypress08/04/2021Licence 306005205

Capacity6
Census5
Date signed10/05/2021 10:35:27 AM
The inspector’s account

Licensing Program Analyst (LPA) Shobhana Frank made unannounced visit to the facility for the purpose of conducting an Annual Required Inspection. LPA Frank arrived at the facility and met with Administrator Melba Santos and explained the reason for the visit.

LPA Frank toured the facility with Administrator Melba Santos which included: Living room, dining area, kitchen, laundry room, 4 bedrooms and 2 bathroom, shaded area, indoor/outdoor activity areas, reviewed medications; medication records, food service, clients and staff records

The facility is a one story house which is Licensed for Adult Residents four ambulatory clients Ages 18 to 59 Years. Currently 5 clients are in care. Each resident bedroom is equipped with the proper furniture and linen supplies.

LPA observed COVID - station equipped with hand sanitizer, thermometer, Gloves, visitors log. LPA observed COVID posters throughout the facility.

LPA observed Facility’s physical plant, hallways appears to be clean and free of debris, free of odor. Sufficient lighting observed throughout the facility. No bodies of water, weapons or ammunition on premises. Smoke detectors and carbon monoxide detector were tested and are operational. Fire extinguishers were fully charged. Fire drill was conducted on 2/1/21. Facility stove, oven, microwave, refrigerator, washer and dryer are clean and operational.

LPA observed 2-day supply of Non-perishable and 7-day supply of perishables food available in the kitchen and refrigerator. Facility refrigerator, frizzier and canned food were inspected. All canned food noted to be within expired date. LPA observed plenty of fresh fruits, vegetable and water available for clients. Meal menus were posted. Kitchen area was free of potential hazards and appeared to be meet sanitary regulations. LPA observed emergency supplies packaged for four days. Comfortable temperature was maintained in the facility; Water temperature was measured at 113.2 degrees Fahrenheit.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction