Facility Evaluation Report

Licensing Program Analyst (LPA) Imaculada Vasquez arrived unannounced to conduct an annual inspection. Upon arrival LPA was greeted by Caregiver, Dania Rebolledo and granted entry. LPA began inspection with introduction and visit purpose. Administrator, Charles Nwapa arrived 30 minutes later.

Resident record review began- Three (3) records were reviewed. LPA reviewed for admission agreement, medical assessment and TB test results, consent forms, identification and emergency information, appraisal needs and service plans, centrally stored medication/destruction records, safeguard for personal property/valuables, and personal rights notification. This facility meets documentation requirements.

Physical Plant and Safety of Environment/Operational Requirements- LPA toured the facility inside and outside. The home is maintained at a comfortable temperature for the clients. Lighting is sufficient for safety and comfort. Water temperature measured 105.1 degrees F. Laundry chemicals, cleaning chemicals, and sharped objects are observed in a locked closet. Medications are observed in another locked closet. LPA verified there is a telephone working at this location (951) 309-8015.

Food Service- Food supply meets the requirement of one (1) week supply of nonperishable and two (2) day supply of perishables food on hand. Foods are dated to assure safety. Food prep areas are clean and organized.