Facility Evaluation Report

Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced visit for the purpose of conducting a required/ annual visit. LPA was greeted and granted entry into the facility by Caregiver Josephine Slafkes and explained the reason for the visit. Administrator Aida Martires arrived during the visit. Administrator Martires has a current administrator certificate expiring on 03/23/2023.

At 12:15 PM, LPA toured the facility with Administrator Martires. Facility has 6 residents in care during today's visit with 3 residents on hospice care. LPA observed residents relaxing in the facility. All residents appeared happy and well taken care of. Facility appears clean and sanitary. All resident rooms had the required elements as well as restrooms stocked with soap/ sanitizer. All rooms are single occupancy. Facility screens all visitors to the facility and LPA observed the screening/ sanitizing station in the facility. Facility utilizes a visitor sign in sheet. Facility takes resident and staff temperatures daily. Facility has covid precaution postings as well as most department postings. Facility does not have the "Let Us No" poster in the entrance of facility. LPA observed the first aid kit has all required items. Facility mitigation plan has been approved. LPA observed an ample supply of emergency food and water. Smoke detectors are hardwired and tested operational during today's visit. Fire extinguishers are fully charged. LPA toured the outside grounds and observed multiple outside visitation areas. LPA observed the locked medication storage area. Residents participate in activities such as exercise and music therapy. Facility has a plan for covid testing residents and staff as needed as well as a plan for isolation and quarantine. LPA reviewed select resident files during the visit and all files are up to date including emergency information. All residents and staff are vaccinated for Covid-19.

Based on the observations made during today's visit, the following violation is being cited per California Code of Regulations Title 22. Exit interview conducted and a copy of this report was left at the facility.