Facility Evaluation Report

Licensing Program Analyst (LPA) Toni Nwala arrived unannounced to conduct an annual inspection. Upon arrival LPA was greeted by facility staff and granted entry. LPA informed staff visit purpose and provided the facility LPA identification. LPA toured the facility with Executive Director Denise Flores.

Resident record review began- Five (5) 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 is meeting documentation requirements.

LPA began review of employee records- Five (5) records were reviewed.

LPA interviews - LPA interviewed five(5) employees.

LPA will need to return to complete the inspection.

Based on the information received during this visit today, there are no deficiency that is being cited per Title 22, Division 6 of The California Code of Regulations.

This report was reviewed with and a copy provided to the facility representative at the time of the exit interview.