Facility Evaluation Report

Licensing Program Analyst (LPA) Janira Arreola conducted an unannounced annual required visit. LPA was granted entry and met with House Manager, Lawrence Santos and spoke with licensee Angelica Ubungen who was informed of the purpose of the visit. At the time of the visit there was (1) staff and (5) residents present.

The facility is a one story home with (5) bedrooms and (2) bathrooms for residents. No pool or firearms are present at the facility. The facility is a residential care home for the elderly approved for (6) non-ambulatory residents only. The licensee has submitted dementia care plan. LPA reviewed the resident records, and based on observation of residents the facility has (1) ambulatory resident, (1) bedridden resident, and (3) non ambulatory residents. Bedridden resident is in a room with (1) exit door. Therefore the facility was cited for accepting residents not compatible with the facility's fire clearance.

Infection Control: The LPA observed the hand hygiene supplies, PPE equipment and cleaning supplies to do regular cleaning of the facility. LPA reviewed the facility's infection control plan.

Physical Plant: Physical plant was observed to be clean and fixtures and furniture were in good repair. LPA observed client bedrooms and bathrooms, kitchen, living areas, and outdoor area. The carbon monoxide detector and smoke alarms were functional. The hot water temperature was read at 120F. LPA observed the hazardous items like cleaners and knifes were kept locked and inaccessible to residents.