Facility Evaluation Report

Licensing Program Analyst (LPA) Claudia Gutierrez made an unannounced visit for the purpose of conducting a Required/Annual Inspection. LPA met with Staff Tiffany Mallari and the purpose of the inspection was discussed. Assistant Administrator (AD) Laura Oudinot arrived at approximately 10:20 a.m.

During the inspection, LPA and Staff Mallari conducted a tour of the inside and outside of the facility, common areas, resident rooms, kitchen, garage and observed the following:

All resident bedrooms had the required furnishings. LPA observed all resident beds had linens and blankets. The backyard has a shaded sitting area. LPA observed residents having lunch and resting in their respective bedrooms. Bathrooms were observed to be free of debris and mildew and faucets and toilets were operational. Water temperature tested at 111.5 -degrees Fahrenheit. LPA observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food as required by regulations. Smoke detectors and carbon monoxide detectors tested operational. Fire extinguisher was observed to be fully charged. Gas stove, microwave, washer, and dryer were all inspected and observed to be operable. Toxic chemicals, cleaning solutions, and disinfectants were observed to be inaccessible to residents. Medication was observed to be centrally stored and locked. LPA reviewed five resident files and two staff files. One of five resident files did not have an appraisal dated or signed in the last twelve months and four of five were incomplete; a Deficiency was cited on today’s date. LPA interviewed three residents and two staff.

Based on the observations made during today’s inspection, one deficiency is being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted, and a copy of this report and appeal rights was left at the facility.