Facility Evaluation Report

Licensing Program Analyst (LPA) Ruth Martinez made an unannounced visit to the facility to conduct a Case Management - Health Checks.

LPA observed three residents in care and two caregivers present. LPA observed residents to be in clean clothes. LPA conducted a tour of the physical plant. LPA inspected the five resident bedrooms and observed them to be free of hazards. LPA observed residents bedrooms to have the required furnishings of a bed, a chair, a chest of drawers, and a lamp. LPA observed resident beds to have clean linens and blankets. LPA observed the lights in each of the resident bedrooms to be operational. LPA inspected the two shared resident bathrooms and observed them to be clean. Bathrooms were equipped with grab bars and non-skid floor mats. LPA measured the hot water at 109.8 degrees Fahrenheit in facility bathrooms. LPA observed the facility has a two day perishable and seven day nonperishable food supply on hand. Facility has an additional food supply in the spare refrigerator located in the garage. LPA observed a first aid kit, emergency water supply and emergency food bucket stored in the closet adjacent to garage. LPA observed all of the facilities utilities to be operational during the visit. Sharps and medications are secured. Fire extinguishers are fully charged with service date of April 9, 2025. Smoke detector/ carbon monoxide detectors are operational during today's visit. LPA toured the backyard, no bodies of water observed. There is a shaded seating area in the front yard and backyard for residents to sit. The exit gates are operational. No obstacles or hazards observed in the backyard. All staff present are background cleared and associated to the facility. No health or safety concerns were observed.

Based on the observations made during today’s visit, no deficiencies are being cited per Title 22, Division 6 of the California Code of Regulations. This report was reviewed with Administrator and a copy of this LIC809 was provided to the facility.