Facility Evaluation Report
On 02/24/2025 at 9:00 AM, Licensing Program Analysts (LPA) Beena Singh and LPA Melody Brown made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPAs met with Administrator Ariel Angeles and was granted entry to the facility. At the time of the visit there were two (2) staff present, and four ( 4) residents present. LPAs Singh and LPA Brown explained the purpose of the visit to Administrator Ariel Angeles.
The facility has 4 bedrooms, in which 3 bedrooms are designated for residents, and 1 bedroom is designated for staff, 2 bathrooms, living room, kitchen, dining area, backyard, and attached garage. The facility is a Residential Care Facility for the Elderly (RCFE) licensed for a capacity of six (6) non-ambulatory residents, one (1) residents may be bedridden. The current census is four (4) residents. The facility has approved hospice waiver for six (6) residents. LPAs Singh and Brown were accompanied by Administrator Ariel Angeles 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 buildings and grounds were free from hazards. Outdoor and indoor passageways were kept free of obstruction. The facility is maintained at a comfortable temperature. LPAs inspected resident bedrooms; they are equipped with required furniture such as: mattresses, night stands, storage space, and sufficient lighting. Although there were no night lights leading to Non-private bathrooms, deficiency will be issued. bathrooms were clean, and appliances were operating appropriately. LPAs observed sufficient furniture and lighting throughout the facility. In addition LPAs observed Resident #2 (R2), Resident #3 (R3) and Resident #4 (R4) have half bed rail and per records review, R2 R3 and R4 do not have a written order from their physician indicating the need for half bed rail for mobility. Deficiency will be issued.
***This is an amended report of LIC 809 Facility evaluation Report issued on 02/24/2025***
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction