Facility Evaluation Report

On today's date, Licensing Program Analyst (LPA) LPA Rosie Quiroz conducted an unannounced visit for the purpose of conducting a required annual inspection. LPA Quiroz was greeted, COVID-19 screened and granted entry into the facility by Caregiver (CG) Nancy Villanueva. LPA Rosie Quiroz explained the nature of the visit. Licensee/Administrator (L/AD) Geisel Sanchez arrived shortly after. Facility indicated screening all incoming visitors prior to entering the facility. Facility is licensed to provide services to Age range 60 and over, Fire Clearance for (5) five Non Ambulatory residents, and (1) one bedridden in Room #1 and has a Hospice Waiver for (6) six residents. Facility currently providing services to (3) three residents on hospice. Administrator Geisel Sanchez has a current Administrator certificate with expiration date of February 12, 2022. AD Sanchez indicated she completed Administrator course on December 21, 2021 and still waiting for new Administrator certificate to be processed and mailed out.

On or about 9:32am, LPA Rosie Quiroz along with (L/AD) Geisel Sanchez began the tour of the inside and outside of the facility. There are four (4) residents in care and there are no active COVID-19 cases in the facility. LPA Quiroz observed one of four residents in their bedroom resting, and three of four residents observed to be resting and watching television in living-room area supervised by caregivers. LPA Quiroz interacted and interviewed with resident's during today's visit. Four of four residents appeared to be clean and well taken care of. LPA Quiroz observed a COVID-19 check in station in the entry of the facility; LPA Quiroz observed required department COVID-19 precautionary postings in the facility as well as hand washing signs throughout the facility. Facility temperature recorded to be 75 degrees Fahrenheit.

All restrooms observed to have a supply of soap, appeared to be clean and water temperatures were recorded to be within 113 degrees Fahrenheit. LPA Quiroz inspected resident’s bedrooms and appeared to be clean. All bedrooms observed to have all required components. LPA Quiroz observed the emergency and disaster and evacuation plan.