Facility Evaluation Report

Licensing Program Analyst (LPA) Christina Valerio arrived unannounced to conduct an annual required inspection. LPA Valerio was met by Licensee/Administrator Martin, and explained the purpose of the visit.

LPA Valerio and Administrator Martin toured the facility to ensure compliance with Title 22 regulations. LPA Valerio observed three resident bedrooms. Bedrooms were observed to be fully furnished, free from odors, and observed to have clean linens. Residents were observed to be watching television in their room and taking a nap. Resident bathroom was observed to have a shower chair, skid mat, trash can, hand rail, and hygiene supplies. The water faucet was measured to deliver water at a temperature of 105.0 degrees F, which is within the required range of 105 - 120. Common areas were observed to be fully furnished with no hazardous items available to residents in care. The kitchen was observed to have appliances in working condition. The facility had an adequate food supply and an emergency supply of food. LPA Valerio observed medications, sharps, and cleaning supplies to be locked and inaccessible to residents in care. The backyard was observed to have a shaded area for outdoor sitting. Emergency exit ways were clear from obstructions.

LPA Valerio reviewed and collected the LIC 500, LIC 308, LIC 610, and liability insurance. LPA Valerio reviewed one staff file and one resident file. All files reviewed were observed to up to date with required documents.

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.