Facility Evaluation Report

On 7/24/24, at 10:09am, Licensing Program Analyst (LPA) Arvin Villanueva arrived to this facility unannounced to conduct their quarterly case management visit due to a current stipulation order in place. The facility is licensed under a probationary license.. LPA met with the facility administrator, Annie Lyn Rodriguez and stated the purpose of the visit. Present in today's visit were 3 residents in care with 2 staff on duty.

At 11am, LPA conducted a physical inspection of the facility. Facility is approved for 6 non-ambulatory elderly residents, fire cleared for 1 bedridden resident, and approved for 1 hospice resident. LPA observed residents were in their bedroom watching TV and being assisted by staff. Room temperature was measured at 72*F and hot water temperature was measured at 114*F in 1 of 3 resident bathrooms. Bedrooms were observed to be clean and good repair. Bathrooms were observed to be maintained and good repair. Medications, sharp objects and toxic chemicals were observed to be locked and inaccessible to residents in care. Fence at the right side of the facility was observed to be leaning. Discussion with administrator Annie Lyn Rodriguez to have a plan in place to repair the fence as soon as possible. At this time, the condition of the fence is not posing health and safety risks to residents and staff.

LPA conducted review of 3 staff and 4 resident records. 3 of 3 staff reviewed have current 1st Aid/CPR certificate. 1 of 4 resident files reviewed need to update their Physician Report (dated 6/6/23). Discussion with Annie Lyn to obtain current medical assessment for 1 of 4 residents as required. LPA reviewed 2 of 4 resident medications and are in compliance at this time.