Facility Evaluation Report

Licensing Program Analysts (LPAs) Sarina Ramirez and Andrew Martinez made an unannounced visit to the facility to conduct a required annual inspection. LPAs met with Administrator, Moody Zebedeus, and House Manager, Nita Manurip, and discussed the purpose of the visit.

The facility is a Residential Care Facility for the Elderly (RCFE) with a license capacity of six (6), current census of six (6), an d an approved hospice waiver of four (4) . LPAs conducted an overall inspection of the facility which included but was not limited to the following:

Physical Plant/Environment: Indoor and outdoor passageways are free of obstruction. The facility does not have a swimming pool or similar bodies of water. The facility has sufficient lighting and is maintained at a comfortable temperature. The facility has sufficient indoor and outdoor space for resident activities. The facility is equipped with operating smoke detectors/carbon monoxide alarms, working laundry equipment, and telephone service. Resident showers, toilets, and hand-washing areas were operating properly. The hot water temperature in both resident bathrooms measured at 107.0 degrees F. Four (4) residents' bedrooms had beds, bed linen, chairs, dresser, storage space and sufficient lighting. The facility has sufficient linens, towels, and personal hygiene items for residents. The facility has posted in a common area, facility license, administrator certificate, facility sketch, residents personal rights, emergency disaster plan and telephone numbers, CCLD complaint poster, and Ombudsman poster.

Food Service: Facility kitchen and dining area are maintained clean. The facility has sufficient non-perishable and perishable food supply for residents in care. Sharps and chemicals were kept locked and inaccessible to residents in care.