Facility Evaluation Report

Licensing Program Analyst (LPA) William Vanegas conducted an unannounced visit for the purposes of conducting an annual inspection. Upon arrival LPA Vanegas was greeted and granted entry to the facility by Facility Manager (FM) Mylene Baldazo. LPA Vanegas explained the purposes of the visit and began a tour of the facility. LPA Vanegas observed the following.

This is a one storied home with four bedrooms three of which are resident rooms, and one of which is a staff room. There is one and a half bathrooms that are both shared. There is a large backyard big enough to participate in outdoor activities upon resident request. LPA Vanegas observed kitchen area to be clean and free of any mildew or debris. LPA Vanegas observed there to be a gas stove, microwave, refrigerator, washer, and dryer all appeared to be in good repair and tested operational. LPA Vanegas observed there to be a seven day supply of non perishable food, and two day supply of perishable food, and a sufficient amount of emergency water on hand for residents in care.

LPA Vanegas observed resident restrooms to be clean and free of any mildew or debris. LPA Vanegas observed restrooms to have all required furnishings such as slip resistant floor matts, grab bars, and a shower chair. LPA Vanegas observed water faucets, and toilets to be operational. Restroom water tested between 117.0 and 118.9 degrees.

LPA Vanegas observed all resident rooms to have all required furnishings such as beds, clean linens in good repair; meaning no strains or tares, chest drawer, a reading lamp, and enough storage for personal items.