Facility Evaluation Report

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of conducting a Required Annual Inspection. LPA was greeted and granted entry by facility caregiving staff after introducing himself and stating the reason of the visit. Administrator Minerva Sansano was notified of the visit and arrived later to assist.

During the inspection, LPA and caregiver conducted a tour of the physical plant and observed the following: The facility is a one-story home with six private resident bedrooms, one staff room and two bathrooms. All resident bedrooms had the required furnishings. LPA observed all beds had linens and blankets and an adequate additional supply is present. The backyard has a shaded area and the routes of egress are free of clutter and obstructions. There are currently six residents in care at the facility, none of which are receiving hospice care. Residents are observed to be clean and appear well taken care of. Bathrooms faucets and toilets were operational. Water temperature was verified to be within acceptable range. LPA observed emergency disaster plan with means of exiting and emergency phone numbers listed and posted. LPA observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food as required by regulations. Combined smoke and carbon monoxide detectors tested operational. Medication and sharp items were confirmed to be inaccessible throughout the physical plant. Medication was however observed to be on the dining room table and multiple cabinets with cleaning products were unlocked. The staff room and laundry area were observed to be locked by facility staff. The medication central storage was also observed to be secure and reviewed for accuracy during the visit. LPA reviewed six resident files and three staff files.

Based on the observations made during today’s inspection, two type A deficiencies and five type B deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted, and a copy of this report along with appeal rights was left at the facility.