Facility Evaluation Report

Licensing Program Analyst(LPA) Christina Valerio arrived to the facility unannounced to conduct a required annual inspection. LPA Valerio met with Administrator Monica Butay, and explained the purpose of the visit.

LPA Valerio observed five (5) staff on shift and three (3) residents in care. LPA Valerio observed staff assisting residents and completing daily duties. Residents were observed taking a nap, eating snacks, and going on an outing. LPA Valerio observed the common areas of the facility to be clean, organized, fully furnished, and without odors. Resident bedrooms were observed to be clean, personalized, and free from clutter or odor. Resident bathrooms were stocked with hygiene supplies. The kitchen was observed to have sharps, medications, and toxins locked away and inaccessible to residents in care. The facility was observed to have an adequate food supply in addition to an emergency supply of food.

LPA Valerio observed resident and staff files. The files were observed to be complete with annual documentation. LPA Valerio observed staff conducting their Medication Administration Record audit for the month of April and completing MARs for May.

LPA Valerio requested the following annual documentation be sent to reza.jamaly@dss.ca.gov: LIC 500, LIC 308, LIC 610, and copy of surety bond.

Per California Code of Regulations (CCR) - Title 22, no deficiencies were observed. An exit interview was held, and a copy of this report was provided.