Facility Evaluation Report

Licensing Program Analysts (LPAs) Jessica Cho and Michael Tea conducted an unannounced Required 1-Year annual visit using the CARE Inspection Tool. Upon arrival at the facility, LPAs Cho and Tea met with Caregiver Rommel DivinaGracia and stated the purpose of the visit followed by Administrator Milany Mora.

The facility is licensed to operate for six (6) non-ambulatory and maintains a hospice waiver of five (5). The facility is a single-story structure located in a residential neighborhood. LPAs toured the physical plant accompanied by Caregiver DivinaGracia at 2:15pm, and the following were observed:

LPAs toured the inside and facility appeared clean, organized, and in sanitary condition. There are a total of six (6) resident and two (2) staff bedrooms. The resident bedrooms were appropriately furnished and the bedding in the resident bedrooms were in good condition. Adequate lighting was provided and storage for personal belongings were observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. There are a total of four resident bathrooms which measured at 122.3, 120.3, 128.0, and 129.4 degrees Fahrenheit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharp objects were stored and inaccessible to the residents. The kitchen was inspected and facility maintains a two-day supply of perishables and seven-day supply of non-perishable food. Medications were centrally stored however the locking mechanisms for the medication cabinets were not working properly. The facility has two fire extinguishers that are charged and serviced on 09/19/2023. Auditory devices and smoke/carbon monoxide detectors were tested and operational. The facility conducted a Fire/Safety Drill on 06/01/2024. A working telephone (949) 393-3120 remains available. First Aid Kit contained all the necessary elements. The 'See Something Say Something' Poster (PUB475) was maintained at 8.5"x11" however did not meet the required size of 20"x26." LPA toured the outside grounds. The exit gates were self-closing and self-latching.