Facility Evaluation Report

Licensing Program Analyst (LPA) E. Conchas made an unannounced visit to the facility. The purpose of the visit was to conduct the required comprehensive annual inspection LPA met with a staff member and was granted entry to the facility. Caregiver Ralp Abano assisted LPA in the tour during the visit. At the time of the visit there were three (3) staff present.

The facility is a six (6) bedroom, two & half (2 & 1/2) bathroom home with a kitchen/dining area, living room/activity room. The facility is licensed for a capacity of six (6) bedridden residents. The facility is approved for six (6) hospice waivers. The current census is six (6) residents. LPA was accompanied by Ralp to conduct a general overall inspection.

The facility is operating in the capacity approved by Community Care Licensing Division (CCLD). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature of 75 degrees Fahrenheit. LPA inspected resident bedrooms which are equipped with required furniture. Bathrooms were clean, and appliances were operating appropriately. LPA observed sufficient furniture and lighting throughout the facility. LPA measured and observed the water temperatures in the bathrooms to be between 109-115 degrees F. The facility is equipped with operating smoke detectors and carbon monoxide alarms. One Fire extinguisher was observed at the facility and was current. Posters such as personal rights, the CCLD complaint poster, labor laws, and the disaster plan were posted in a common area.

LPA observed non-perishable and perishable food supply that was sufficient for the number of residents in care.

LPA observed sharps, and other dangerous items were kept inaccessible to residents in care. There was a designated locked storage space for residents, staff, facility files, first aid kit and medication.