Facility Evaluation Report

Licensing Program Analyst (LPA)Andrea Mendivil conducted an unannounced visit for the purpose of conducting a required/ annual visit. LPA was greeted and granted entry into the facility by Caregiver Charlie Bernardo and Mary Joy Bernardo and explained the reason for the visit. At 2:02pm Administrator Moneli Sharifan arrived.

At 1:06 PM, LPA toured the facility with Caregiver Mary Joy . Facility is 5 bedroom, 2 bathroom single story home with a detached garage, Facility has 6 residents present during today's visit. LPA observed residents relaxing in the facility. Facility appears clean and sanitary. All residents rooms had the required elements as well as restrooms stocked with soap/ sanitizer. LPA observed the screening/ sanitizing station in the entrance of the facility. Facility uses a handwritten sign in/ questionnaire. Facility takes residents and staff temperatures daily and documents. The facility mitigation plan has been completed and approved. LPA observed emergency food and water. LPA observed locked medication cabinet. LPA toured the outside grounds and observed outside shaded visitation area. Exit gate is unlocked and self latching. Facility has a plan for covid testing residents and staff as needed as well as a plan for isolation. LPA observed a 4 weeks supply of PPE. LPA reviewed all residents files and all contained required documentation including updated emergency information.