Facility Evaluation Report
Licensing Program Analyst (LPA) Edward Tapia made an unannounced required annual inspection at this facility. LPA met with staff and stated the purpose of this visit. Licensee Adriel Pao arrived after the inspection.
The facility is a single level structure and licensed for six non-ambulatory of which six with a hospice waiver for four. One may be bedridden. This facility is a Residential Care Facility for the Elderly.
At about 11:41 am, LPA Tapia was granted entry after completing the Coronavirus 2019 (COVID 19) screening procedure. For this visit, LPA observed 4 residents in care and 2 staff members on duty. LPA toured the interior and exterior portions of the facility. There were 5 resident rooms 1 of which is a shared room. The facility also had 2 staff rooms where inaccessible to residents. LPA noticed no lock for one of the staff rooms. Licensee was made aware of this and will purchase a lock. Resident rooms were provided with furniture in good repair, clean linens, adequate storage space, and kept free of tripping hazards. LPA noticed medications in one room. LPA checked the resident’s physician report and they are not able to self-administer medications. Licensee was made aware of citation and removed medications from resident’s room. Manual smoke detectors, carbon monoxide and auditory exit alarms were tested to be operational. Bathrooms were observed to be in good repair and provided with grab bars and hot water was measured from 111.2. degrees Fahrenheit. Facility had adequate supplies of personal protective equipment in place. Fire extinguisher was observed. Facility offers a 2-car garage which is used for storage with a refrigerator, freezer and a recreational section for staff. Kitchen was kept clean and in good repair with sharps kept locked. LPA noticed stove top was not able to turn on without an ignitor. Licensee was made aware of this and will purchase a new stove/repair stove. Facility met the minimum two-day supply of perishable and seven-day supply of non-perishable food stock requirements.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction