Facility Evaluation Report

Licensing Program Analyst (LPA) Magda Malcore made an unannounced visit to the facility to conduct a required comprehensive a nnual inspection. LPA was granted entry and met with Administrator, Victor Mercado to discussed the purpose for the visit. The facility is a Residential Care Facility for Elderly (RCFE) with a license capacity of (8), and a current census of (3). LPA conducted a general inspection of facility, which included, but was not limited to, the following:

Operation/Physical Plant: Indoor and outdoor passageways were kept free of obstruction. The facility has no swimming pools or similar bodies of water. The facility has sufficient indoor and outdoor space for resident activities. The facility is maintained at a comfortable temperature of 73 degrees F. Resident bedrooms were furnished with beds, night stands, chairs, bed linen and lighting. LPA observed one of the resident's bathroom is not being utilized. The Administrator stated that the water supply in resident shower is shut-off due to "rust like" water coming out of shower fixture and not operating properly for a couple of months. The facility is equipped with operating carbon monoxide alarms, fully charged fire extinguishers, laundry equipment, and telephone service. The facility has posted in a common area Community Care Licensing complaint poster, Ombudsman poster, and personal rights. LPA observed motor oil, ZEP cleaning solutions, bug insecticide spray kept unlocked and unattended in the facility's backyard area.

Food Service: Kitchen and dining areas were maintained cleaned. Non-perishable and perishable food supply was sufficient for number of residents in care. **continued on next page**