Facility Evaluation Report

Licensing Program Analyst (LPA) Christina Valerio arrived unannounced at the facility to conduct an annual inspection. LPA met with facility staff, and explained the purpose of the visit.

Facility Staff and LPA Valerio toured the physical plant to ensure compliance of Title 22 regulations. LPA observed the kitchen to have an emergency supply of food, a locked cabinet for sharps and cleaning supplies, a supply of perishable foods for seven days, and a supply of non-perishable food for a minimum of two days. Resident rooms were furnished with required furniture and were clean and free from debris. Resident bathrooms were fully stocked with necessary items, including soap, hand sanitizer, paper towels, and a trash can with a lid. The fire extinguisher was fully charged with last check on 12/2022. The facility was observed to have a 30-day supply of PPE and an emergency supply of food/water. Technical Assistance was provided for a bathroom sink. While LPA was checking the water temperature, the pipe burst and started to spill out water. Facility staff will inform administrator.

Residents were observed to be taking a nap, watching television, and a few in their room.

LPA requested the following: Administrator Certificate, LIC 308 - Designation of Administrator Responsibility, LIC 610-D, and LIC 500 Personnel Summary

Per the California Code of Regulations, Title 22, no deficiencies were observed or cited. Exit interview held with facility staff, and a copy of the report was provided.