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 Mariana Gonzalez after explaining the purpose of the visit. LPA observed the Administrator certificate was current and expires November 28, 2026. This is a Residential Care Facility for the Elderly (RCFE) licensed to six non-ambulatory residents with a hospice waiver for six. The facility is a one story home with three resident bedrooms, one staff bedroom, two bathrooms, and an attached garage.

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

LPA observed residents watching television in the living room and respective bedrooms. LPA observed six residents in care and two staff present. LPA observed the See Something Say Something Poster (PUB 475) was posted by the facility entrance. 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. Per observation and staff interview, Resident 4 (R4) requires assistance in turning and repositioning in bed and is unable to independently transfer to and from bed. Staff uses hoyer lift to transfer resident; a deficiency was cited.

LPA observed bathrooms were clean and equipped with grab bars and non skid floor mats. Bathrooms were observed to be free of debris and mildew, faucets and toilets were tested operational. Water temperature tested between 113.1 and 130.5 degrees Fahrenheit. LPA toured the outside of the facility and all passageways were free of obstruction. LPA observed the backyard had a shaded sitting area with furniture for resident use.