Facility Evaluation Report

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility to conduct the required annual inspection. LPA was greeted and granted entry by administrator Troy Ujimori after stating the purpose of the visit.

There are currently three residents in care, one of which is receiving hospice care at this time. LPA observed residents relaxing in their respective bedrooms or in the facility's common living areas. LPA accompanied by facility staff toured the physical plant. The facility is a two-story house with four private bedrooms (one of which is vacant) and one shared room which is also vacant. There are two shared bathrooms used by residents, one of which is en-suite from the shared bedroom. Licensee stated their intent to host visiting family members in the shared bedroom and was provided with a consultation regarding the requirement to obtain a clearance and association to the facility ahead of time.

All occupied bedrooms appear clean and sanitary. One resident uses half-length rails for postural support, but no physician orders are on file. Type B deficiency issued. All resident bedrooms have the required furnishings. Bathrooms appear clean and sanitary and are equipped with grab bars and slip mats. Hot water temperature measured at 109F in one of the bathrooms used for personal grooming.

LPA observed the kitchen has a minimum two (2) day perishable and seven (7) day non-perishable food supply. Sharp items, cleaning supplies and the medication central storage are verified to be secure.