Facility Evaluation Report

Licensing Program Analyst (LPA) Jessica Cho arrived unannounced for the purpose of conducting the Required 1-Year annual evaluation using the Care Inspection Tool. LPA was greeted and granted entry by Caregiver John Moralida and explained the reason for the visit. Administrator (Admin) Maryam Alamoutinia arrived on premise to assist with the inspection.

The facility is a single story structure and is licensed to operate for five non-ambulatory residents of which one may be bedridden and maintains a hospice approved for two. There are no residents on hospice during today's visit. During the tour of the physical plant, LPA observed six resident bedrooms and five resident bathrooms with one additional bedroom occupied by two staff. Resident bedrooms had all required furnishings. Bathrooms were found to be in compliance, clean, and operational, however the hot water temperature measured at 137.8, 134.7, 133.1, 135.6, and 129.2 degrees Fahrenheit. All common areas were inspected including the attached two car garage. LPA observed sufficient emergency food and water. 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 in the kitchen and garage. 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. The fire extinguisher was serviced on March 8, 2024, The auditory devices and smoke/carbon monoxide detectors were tested and operational.

Emergency evacuation drills are conducted quarterly with last drills on March 28-29, 2025. The first aid kit contains all necessary elements. The Complaint Poster, 'See Something, Say Something,' (PUB 475) was available and posted in the incorrect size.