Facility Evaluation Report

Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to conduct the required annual inspection. LPA was greeted and granted entry by staff. Facility is licensed for 6 non-ambulatory residents with a hospice waiver for 6. Facility is a single story home with 6 bedrooms (1 is for staff and 1 is shared), 3 bathrooms, living room with a screened fireplace, dining room, kitchen, laundry room and an attached 3 car garage. LPA observed the PUB 475 (See Something, Say Something poster) sign posted in the main entry of the facility. LPA met with Administrator Maria Avila and explained the reason for the visit. The Administrator's certificate expires on June 11, 2026. LPA and staff toured the facility. LPA observed the kitchen is clean and organized. LPA observed a 2 day perishable and a 7 day non-perishable food supply on hand in the kitchen. LPA observed the knives are kept locked in a kitchen drawer. Cleaning supplies are kept locked under the ktichen sink. LPA observed medication is kept locked in a cabinet in the kitchen. LPA inspected the first aid kit. The first aid kit has all the required elements. LPA observed the fire extinguisher in the kitchen is fully charged. LPA observed Smoke detectors/carbon monoxide detectors tested operational. The last emergency drill was conducted on March 1, 2025. LPA observed all bathrooms are clean and operational. Hot water measured 108.6 degrees Fahrenheit in shared bathroom in the hallway. LPA observed the laundry room is kept locked. LPA observed the garage is kept locked and used for storage. No obstacles or hazards observed inside of the facility. LPA toured the backyard. LPA observed a covered patio with shaded seating to sit outside. The exit gate is operational. No bodies of water observed. No obstacles or hazards observed outside of the facility. LPA reviewed 6 resident files and medications. No discrepancies observed. LPA reviewed 2 staff files. Both staff members are background cleared and associated to the facility. Both staff members have the required training. LPA observed both staff members (Staff 1 & 2) had negative TB tests but did not have completed health screenings (LIC 503) in their files.