Facility Evaluation Report

On 9/26/23 at approximately 9:15am Licensing Program Analyst (LPA) Jennifer Fain arrived at this facility unannounced to conduct an annual inspection visit. LPA met with the administrator Thelma Casugay 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 4 bedrooms and 3 bathrooms for resident use. LPA also conducted the inspection using the CARE tool. Facility currently provides care for 6 non ambulatory residents.

Facility Observation: Upon entry the residents were at day program. LPA observed a nearly completed puzzle on a table with other puzzles on a shelf. Games and art supplies were available. An electric keyboard was observed which administrator said was used for afternoon music.

During this inspection 6 of 6 resident files and 2 staffing files were reviewed for regulatory compliance. Staff files contained required contents including staff training requirements. All staff noted on LIC 500 contained criminal background clearances..

Resident files reviewed contained all required contents including updated admission agreements, medical assessments, and updated appraisal forms as required.

Water temperature in common bathroom reads 112*F which is within the regulated temperature range of 105*F to 120*. Temperature on the heating and air unit read 75*F. LPA observed the facility to have adequate food supply. .