Facility Evaluation Report

Licensing Program Analysts (LPAs) Sarina Ramirez and Mary Rico conducted a health and safety visit to the facility. LPAs met with Staff, Rose Penilla, and informed the purpose of the visit.

LPAs observed four (4) residents and two (2) staff at facility, one (1) resident was out in the community with S4. Based on record review S4 is not associated to the facility, citation and civil penalty issued. LPAs conducted a tour of the inside and outside of facility. The facility has sufficient food supply for residents, however LPA observed expired non perishable foods; deficiency issued. Air conditioning and bathroom equipment is running properly, however LPAs observed dirty water from the residents shower head and sink faucet. The facility does not have clean running water for the residents. In addition, the hot water measured over 120 degrees F, citation issued. Staff working stated that Adam Barone does not work or live at the facility.

Resident files were not available for review, citation issued. LPA observed roaches in the main hallway near the dining room, citation issued. After reviewing the facility's floor plan, LPAs observed the Licensee converted their living room into a staff bedroom. During staff interviews S1 and S2 confirmed they sleep in the living room. Furthermore, the Licensee also converted resident's room number 1 into a personal bedroom for Licensee family, citation issued. Based on record review family member/S3 does not have a criminal record clearance, citation and civil penalties issued.

An exit interview was concluded where this report, LIC 809D, LIC421BG, and Appeal Rights were discussed and a copy was provided to Administrator Caroline Armstrong at the conclusion of the visit.