Facility Evaluation Report

On 10/28/2024 at 11:20 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 was one (1) staff present, and two (2) residents present. Administrator Brandon Marquez and Licensee Sandy Zhao was contacted and informed of the visit. Administrator Marquez was not at the facility during the visit. LPA Brown explained the purpose of the visit to staff Sahian Suarez Camacho..

The facility is a four (4) bedroom, two (2) bathroom home with a kitchen/dining area, living room, activity room and laundry area. 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. The facility has six (6) Hospice Waiver. The current census is two (2) residents. LPA Brown was accompanied by staff Camacho 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). The facility is equipped with operating smoke detectors but LPA Brown observed no carbon monoxide at the facility. Deficiency will be issued. LPA Brown observed no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature of 107 degrees Fahrenheit. LPA Brown inspected resident bedrooms; they are equipped with required furniture such as mattresses and storage space, however, LPA Brown observed missing one (1) chair and one (1) lamp in resident #1 (R1) and resident #2 (R2) bedroom. Technical Violation issued. Moreover, LPA Brown observed that bathrooms were clean, and appliances were operating appropriately. LPA Brown observed grab bars and the customized bathroom tiles in the resident bathrooms. ***Continuation in LIC809C ***