Facility Evaluation Report

On today's date Licensing Program Analyst (LPA) William Vanegas made an unannounced visit for the purposes of conducting an annual inspection. Upon arrival LPA was greeted and granted entry to the facility by care giver staff. LPA explained the purpose of the visit and facility staff advised Administrator (AD) Ashkan Bastani of my arrival. AD arrived shortly after to assist with the tour of the facility. LPA began a tour of the facility and observed the following AD has a valid Administrator certificate that expires on October 22,2027.

The facility is a one storied home with six bedrooms, one of which is a staff room, and five of which are used for residents in care, three restrooms, and a two car attached garage. LPA observed facility to have all required postings in the facility along the entryway hallway. LPA observed the PUB475 (See something, say something) poster posted on the wall. As well as the long term care ombudsman poster, resident rights, and rights to have a resident council posted on the wall. LPA observed kitchen area to be clean and free of any mildew and debris. LPA observed there to be a gas stove, microwave, refrigerator, dishwasher, washer, and dryer. All were observed to be in good condition and tested operational. LPA obsereved a two day supply of perishable food, and a seven day supply of non-perishable food.

LPA Observed all resident rooms to be clean and free of any debris. LPA obsereved residents to have all required furnishings such as a chest of drawers, a bed, clean linens in good repair; meaning no strains or tares, a reading lamp, a chair, and enough storage space to store personal belongings. LPA observed rooms large enough to walk about freely, and no furniture blocking the entry ways.