Facility Evaluation Report
On 09/22/2024 at 11:15 AM, Licensing Program Analyst (LPA) Melody Brown made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA Brown met with Licensee/Administrator Aurea Arquisola and was granted entry to the facility. At the time of the visit there was one (1) staff present, and one (1) resident present. LPA Brown explained the purpose of the visit to Licensee/Administrator Arquisola.
The facility is a five (5) bedroom, two (2) bathroom home with a kitchen/dining area, living room/activity room, laundry area and attached two (2) car garage. The facility is Residential Care Facility for the Elderly (RCFE). Facility is Licensed for a capacity of three (3) residents, with a fire clearance for one (1) ambulatory and two (2) non-ambulatory of which one (1) can be bedridden in room #1. Facility has current hospice waiver for three (3). At the time of the visit census was one (1) resident. LPA Brown was accompanied by Licensee/Administrator Arquisola to conduct a general overall inspection, which included, but was not limited to the following:
Physical Plant : The facility is operating in the capacity approved by Community Care Licensing Division (CCLD). LPA Brown observed no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature of 76 degrees Fahrenheit. LPA Brown inspected resident bedrooms; they are equipped with required furniture such as: mattresses, lamps, night stands and storage space. LPA Brown observed sufficient lightning. Moreover, LPA Brown observed that bathrooms were clean, and appliances were operating appropriately. LPA Brown observed grab bars and non-skid mat in the resident bathrooms. Hot water temperature was measured in resident’s bathroom and observed 106 degrees Fahrenheit.
In addition, LPA Brown observed bedrooms designated for resident’s use are room #1 and room #2. Bedrooms # 3, #4, and #5 are currently been used by Licensee and family, all adults residing in home have appropriate criminal background clearances and associations to facility. LPA Brown observed an adequate supply of extra linens and towels. ***Continuation in LIC809C ***
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction