Facility Evaluation Report

Unannounced Annual visit made out to this facility on 03/29/2024 by Licensing Program Analyst (LPA) Charlie Yang who was met by the facility designated Administrator Mauricio Perez and Susana Perez who were briefly interviewed.

It was learned that Mr. and Mrs. Perez were the Licensee(s) and facility designated Administrators at this time. They are also the live-in personnel at this facility at this time.

There were (2) residents under the care of hospice at this time.

There weren't any residents receiving the services of home health at this time.

Administrator certificate was observed to be present and in compliance at this time for facility designated Administrator Susana Perez. Additional forms and documents were reviewed to make sure that the renewal process was initiated prior to the certificate expiration date of 07/14/2024 with certificate # 6018430740.

Kitchen area was toured. Cabinets and drawers were reviewed.

Food supply was reviewed for adequate 2-day perishable and 7-day nonperishable quantities at this time. A tour of the dining area, living area, and all other areas intended for resident use was conducted.

Medication cabinet and supplies, located in the entry way closet, was reviewed. Policies and procedures involving dispensing, documenting, and overall administration of resident medications was discussed with the facility designated Administrators at this time. This medication cabinet was observed to be locked and made inaccessible to the residents at this time.

A tour of the resident bedrooms and restrooms was conducted. Furniture and furnishings were observed to be sufficient and able to meet the needs of the residents at this time.

Hot water temperatures were taken and measured to make sure that they were within the allowed range of 105-120 degrees.

Linen closets were observed to contain a sufficient supply of towels, blankets, and linens to meet the needs of the residents at this time.