Facility Evaluation Report

On 9/18/23 at approximately 10am Licensing Program Analyst (LPA) Jennifer Fain arrived at this facility unannounced to conduct an annual inspection visit. LPA met with the administrator Ma Magnolia Tolon and explained the purpose of the visit.

LPA inspected the physical plant including but not limited to the kitchen, dining room, resident bedrooms, resident bathrooms, laundry room, living area, common TV area, and outside of the facility to ensure compliance with Title 22 regulations. Facility has 6 bedrooms and 5 bathrooms for resident use. LPA also conducted the inspection using the CARE tool. Facility currently provides care for 1 ambulatory resident and 5 non ambulatory residents.

Facility Observation: Upon entry the residents were in the common area or in their rooms watching tv or on personal devices. Staff checked in with residents every 20- 30 minutes. Lunch was served at the kitchen table or in resident rooms. The lunch menu was beef with potatoes and fruit. 2 families visited residents in the morning. LPA observed staff working with residents on their physical therapy.

During this inspection 6 resident files and 2 staffing files were reviewed for regulatory compliance.

Staff files contained required contents including staff training requirements.

3 of 6 Resident files reviewed contained all required contents including updated admission agreements, medical assessments, and updated appraisal forms as required. Facility has 1 resident with half bedrails with physician orders in place.