Facility Evaluation Report

Licensing Program Analyst's (LPAs) Paola Guerrero and Ryan Gardner made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA met with Facility Caregiver Rosy Rivera and was granted entry to the facility. At the time of the visit there was four (4) staff present, and thirteen (14) residents present and eight (8) residents were out in the community. The facility is a Residential Care Facility for Elderly (RCFE) Licensed capacity is (24) current census (23). LPA was accompanied by Facility Administrator Joney and Caregiver Rosy, to conduct a general overall inspection, which included, but was not limited to, the following:

Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). While conducting a walk through of the facility LPAs observed facility vent to be covered with accumulating dust. LPAs also observed two resident bathrooms to have broken tiles. In addition, LPAs observed black build-up on bathroom tile and ceiling. Water temperature in building #1 measured at 130.9 exceeding regulation requirements. LPAs observed that facility did not have skid mats in restrooms. During walk through LPAs observed that facility has two separte buildings with no signal systems facility has a census of 23 residents. LPA inspected resident’s bedrooms; they are equipped with required furniture such as: mattresses, nightstands, storage space, and sufficient lighting; The facility is equipped with operating smoke detectors and carbon monoxide alarms. Posters such as personal rights, the CCL complaint poster, and the disaster plan were posted in a common area. During walk through LPAs observed Cleaning supplies such as bleach to be accessible to residents, LPAs had caregiver secure bleach by locking laundry room door. There was a designated storage space for resident/staff files. Medications are kept inside staff office inaccessible to residents in care.

Food Service: Non-perishable and perishable food supply is sufficient for number of residents in care. While completing food inspection LPAs observed expired canned jalapenos along with diced green chili cans.

Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. All staff members working in the facility have criminal record clearance through the department.