Facility Evaluation Report

Licensing Program Analyst (LPA) Christina Valerio arrived to the facility unannounced to conduct an annual required inspection. LPA Valerio met with facility staff, and explained the purpose of the visit. LPA Valerio contacted Administrator Sherry via cell phone. LPA Valerio was later met by Administrator Sherry Ahuja.

The facility has an approved hospice waiver for six (6) residents. One (1) resident may be bedridden and reside in bedroom #5 only.

LPA Valerio toured the facility to ensure compliance with Title 22 regulations. LPA Valerio observed resident bedrooms. Bedrooms were fully furnished and free from odors. LPA Valerio spoke to three (3) residents. Residents were observed sleeping or laying down watching television. LPA Valerio observed groceries being delivered. LPA Valerio observed resident bathrooms. The hot water temperature was measured in two (2) bathrooms and were observed to be 105.6 degrees F and 110.1 degrees F. LPA Valerio observed common areas to be fully furnished. The facility had fans in the common areas and in resident bedrooms. The air conditioning thermostat was set to 75 and the temperature was 81 degrees. According to administrator, they have someone coming out to fix the a/c. LPA Valerio observed the kitchen area. The facility was observed to have a minimum of two day supply of perishable food items and a seven day supply of non perishable food item. All sharps, medications, and toxins were observed to locked and inaccessible to residents in care. LPA Valerio observed the exterior area. The front exterior is surrounded by a gate, which was observed to be unlocked. The backyard exterior area was observed to have no emergency exit ways obstructed or blocked.

LPA Valerio reviewed staff and resident files. Files were current with up to date documentation.

LPA Valerio requested the following annual documentation: LIC 500, LIC 308, LIC 610, copy of liability insurance. Per California Code of Regulations (CCR) - Title 22 - no deficiencies were cited. An exit interview was held, and a copy of this report was provided.