Facility Evaluation Report

Licensing Program Analyst (LPA) Imaculada Vasquez arrived unannounced to conduct an annual inspection. Upon arrival LPA was greeted by Caregivers, Jose Itchon and Michelle Hashimoto and granted entry. Administrator, Claire Itchon Camua arrived five (5) minutes later. LPA began inspection with introduction and visit purpose. There are currently Five (5) residents living at the facility. The single story facility consists of three (3) bedrooms and two and a half (2.5) baths.

Resident record review began- Two (2) 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 118.9 degrees F. Laundry chemicals, cleaning chemicals, and sharped objects are observed in a locked cabinet. Medications are locked in a cabinet in office. LPA verified there is a telephone working at this location (760) 322-8528.

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