Facility Evaluation Report

Licensing Program Analyst (LPA), Robert Campbell arrived at the facility unannounced to conduct the Required Annual Inspection and met with Rhellynick Sevillano -Administrator . The facility file review was conducted in the Regional Office and additional forms were requested and reviewed on site. The facility is licensed for six (6) Elderly Adults.

LPA toured the facility along with Administrator, Rhellynick, and made observations pertaining to the one year required annual. The facility was inspected inside and outside, there were no obstructions or debris to the indoor or outdoor passageways currently. The facility is a two-story home located at 43895 Bluewood Circle Temecula, CA 92592.

Physical Plant: The facility phone number is (951) 414-9381 and is currently operable. LPA observed all three residents’ bedrooms, and each was equipped with required furniture as per Title 22. LPA inspected the two facility bathrooms, and the hot water temperature tested within regulations. The bathrooms were clean, and appliances were operating appropriately currently at the time of this visit. The facility is equipped with operating smoke detectors, carbon monoxide alarms, and fire extinguishers. LPA observed required postings such as "If you See Something, Say Something" the "Personal Rights." The cleaning supplies and sharp items were kept locked and inaccessible to the residents in care. There was a designated storage space for the residents and staff files, and it was locked and inaccessible to residents in care currently at the time of this visit.

Medications : Were locked and inaccessible to residents in care, and there was a sufficient supply of medication for each resident. The medications were not observed to be pre-filled during this inspection, and the Fire and/or Disaster Drills were logged and conducted quarterly. (Continued to 809-C)