Facility Evaluation Report

Licensing Program Analyst (LPA) Nancy Guillen made an unannounced visit for the purpose of conducting a required annual Inspection. LPA was greeted and granted entry by care provider after explaining the purpose of the visit. Administrator (AD) Cotila Dahabreh was notified via telephone and later arrived to assist with the inspection. LPA observed the Administrator certificate was current and expires January 27, 2027. This is a Residential Care Facility for the Elderly (RCFE) licensed to six non-ambulatory residents with a hospice waiver for three. The facility is a one-story home with six resident bedrooms, one staff bedroom, four bathrooms, and an attached garage.

During the inspection, LPA and AD conducted a tour of the inside and outside of the facility, common areas, resident rooms, kitchen, garage and observed the following:

LPA observed residents washing dishes and watching television in the living room and respective bedrooms. LPA observed three residents in care and two staff present. LPA observed the See Something Say Something Poster (PUB 475) was not posted at the facility, the framed poster was brought from storage and placed back on the wall during visit. All resident bedrooms had the required furnishings. LPA observed all resident beds had linens and blankets with additional linens stored in the hallway storage closet. LPA observed bathrooms were clean and equipped with grab bars and non skid floor mats. LPA observed all windows were appropriately screened. Bathrooms were observed to be free of debris and mildew. Faucets and toilets were operational. Water temperature tested between 125.7 and 130.6 degrees Fahrenheit. LPA toured the outside of the facility and observed spray paint, paint, sealer and pruning shears in unlocked back patio storage; items were removed and placed in garage during visit. LPA observed the backyard had a shaded sitting area with furniture for resident use.