Facility Evaluation Report

On 7/30/2023, at 12:30 p.m., Licensing Program Analyst (LPA) Janette Romero arrived unannounced at the facility to conduct an annual required visit. LPA was greeted and granted entry by Caregiver Maricel Francia who was informed of the purpose of visit. Licensee Teodora San Juan arrived during LPA's tour of the facility's interior and exterior. The facility is approved for 6 non-ambulatory residents of which one (1) may be bedridden. The facility has a hospice waiver for two (2). During the visit, there was four (6) residents and (2) staff present.

LPA toured the dining and living/family room area. LPA observed area to be clean and furniture in good condition. LPA observed residents in their rooms watching television and sleeping. Hallway was clean with no pathway obstruction. Facility has a fire alarm system, carbon monoxide and smoke detectors. Facility has a first aid kit with required components. Medications were secured in a locked hallway cabinet. LPA reviewed physical medications for Resident #1 as well as Medication Destruction Record, no discrepancies discovered. Bathroom has a working toilet, wash basin, and were equipped with a grab bar in the shower. The hot water temperature measured at 105-degrees Fahrenheit. The facility has clean towels, blankets, and linen, available in different colors for the residents in care. Emergency food supplies, water, additional hygiene supplies and incontinent supplies are stored in the garage. Shaded seating area is available for the residents to sit and relax. All outdoor pathways were free of obstructions. No bodies of water were observed.