Facility Evaluation Report

Licensing Program Analyst (LPA) Jessica Cho arrived at the facility unannounced for the purpose of conducting the Required 1-Year annual inspection using the CARE Inspection Tool. LPA was greeted and granted entry by House Manager (HM) Concepcion Jimenez after explaining the purpose of the visit. Administrator (Admin) Lisa Gaitan arrived and assisted with the inspection.

The facility is a single story structure located in a residential neighborhood. Facility is licensed to operate for six (6) non-ambulatory and maintains a hospice waiver for four (4) residents. There are three residents in care during today's visit with one caregiver and HM on duty.

LPA observed the facility to be clean and sanitary. There are six resident bedrooms and two resident bathrooms. One additional bedroom is occupied by the HM who is a live in staff. All common areas were inspected including the attached two car garage and office/medication room. The residents' bedrooms were appropriately furnished. Beds and bedding supplies were in good condition, adequate lighting was provided, sufficient storage space for each residents' personal belongings were observed. Bathrooms were found to be in compliance, clean, and operational. The water temperature measured at 108.6 and 109.2 degrees Fahrenheit. Toxins, disinfectants, sharps, and medications were secured and inaccessible. LPA observed sufficient two-day supply of perishables and seven-day supply of non-perishable food available. 18 non-perishable food items were observed expired and were immediately discarded during the visit. LPA toured the exterior portion of the facility. The outdoor passageway is free of obstruction. The exit gate was self-closing and self-latching. LPA observed sufficient seating and shading. Facility maintains a fire extinguisher which was observed mounted, charged, and serviced on October 1, 2024. The auditory devices and smoke/carbon monoxide detectors were tested and operational except for one auditory device in one out of the six resident bedrooms. In the same resident bedroom, the screen door handle was loose and a tear was present on the screen sliding door.