Facility Evaluation Report

Licensing Program Analyst (LPA) Andrea Mendivil conducted an unannounced visit for the purpose of conducting a required annual visit. LPA was greeted and granted entry into facility by House Manager Danilo De Guzman and explained the reason for the visit.

At 9:15 AM, LPA toured facility with House Manager Danilo De Guzman. Facility has 5 residents present during today’s visit. Facility is a 5 bedroom, 2 bathroom, single story home with an attached garage. LPA observed a screening and sanitizing station at entrance of the facility. LPA observed residents relaxing in the facility or in their respective rooms. Facility appears clean and sanitary. All resident rooms had required elements, including bed, chair, closet space and ample lighting. Restrooms are stocked with soap and paper towels and have hand washing postings. Facility has 2 refrigerators with ample food supply. LPA observed facility has emergency food and water supply. Facility has a secured location for resident medication and files. LPA toured the outside grounds and observed outside visitation area. Exit gates are unlocked and self latching. Facility has a plan for covid testing residents and staff as needed as well as a plan for isolation. LPA observed a 4 weeks supply of PPE. LPA reviewed all residents’ files and all contained required documentation including updated emergency information. All staff and residents are fully vaccinated for Covid 19.

No deficiencies noted during today's visit. An exit interview was conducted and a copy of this report was left at the facility.