Facility Evaluation Report
On 09/21/2024 at 11:15 AM, Licensing Program Analyst (LPA) Melody Brown made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA Brown met with a staff and was granted entry to the facility. At the time of the visit there were two (2) staffs present, and six (6) residents present. LPA Brown met with Administrator Dominic Garcia and LPA Brown informed Administrator Garcia of the purpose of the visit. Administrator Garcia left during the visit due to personal appointment. Administrator Garcia authorized Staff #4 (S4) to receive and sign the reports of the visit today. LPA Brown explained the purpose of the visit to Staff #2 (S2) and S4..
The facility is a five (5) bedroom, three (3) bathroom home with a kitchen/dining area, living room, laundry area and attached three (3) car garage. The facility is Residential Care Facility for the Elderly (RCFE). The facility is licensed for a capacity of six (6) residents of which six (6) can be non-ambulatory residents where one (1) may be bedridden. The facility has six (6) Hospice Waiver. The current census is six (6) residents. LPA Brown was accompanied by S2 to conduct a general overall inspection, which included, but was not limited to the following:
Physical Plant : The facility is operating in the capacity approved by Community Care Licensing Division (CCLD). LPA Brown observed no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature of 74 degrees Fahrenheit. LPA Brown inspected resident bedrooms; they are equipped with required furniture such as: mattresses, lamps and storage space. LPA Brown observed sufficient lightning. Moreover, LPA Brown observed that bathrooms were clean, and appliances were operating appropriately. LPA Brown measured the hot water at residents shared bathroom and LPA Brown observed 108 degrees Fahrenheit. LPA Brown observed grab bars and non-skid mat in the resident bathrooms. ***Continuation in LIC809C ***
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction