Facility Evaluation Report

Licensing Program Analyst (LPA) Christina Valerio arrived unannounced to conduct an annual required inspection. LPA Valerio met with Ma Theresa Mata, and explained the purpose of the visit.

LPA Valerio observed 1 staff on shift and 0 residents present at the facility. Residents left for their day program. LPA Valerio and Administrator toured the facility. Resident bedrooms were observed to be clean, fully furnished, and free from any odors. Resident bathrooms were sanitary and stocked with hygiene supplies. Common areas were observed to be fully furnished, organized, and free from debris. The living room area was furnished with the resident's favorite chair or couch of choice. No emergency exits were observed to be obstructed. The kitchen was observed to have fully operational appliances and clean countertops. The facility met food requirements. Residents have access to the refrigerator and pantry for snacks. The fire extinguisher, carbon monoxide detectors, and central heating/air condition appeared to be in working condition. The facility's last emergency drill was conducted on 11/04/2024. LPA observed all medications, sharps, and cleaning supplies to be locked and inaccessible to residents in care. The exterior area was observed to be well maintain with no hazards.

LPA Valerio observed two (2) resident files and two (2) staff files. All files were observed to be complete with up to date documents.

LPA Valerio requested the following annual documentation be sent by 12/02/24: LIC 500, LIC 308, LIC 610, and a copy of the Surety Bond.

Per California Code of Regulations (CCR) - Title 22, no deficiencies are being cited on today's visit. An exit interview was held with Administrator, and a copy of the report was left at the facility.