Facility Evaluation Report

Licensing Program Analyst (LPA) Dang Nguyen made an unannounced visit to conduct a Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with Caregiver Arminda Flores. LPA then met with Licensee/Administrator Elena Guilas, who arrived shortly after.

According to the facility’s license, the facility has a maximum capacity for six (6) clients, of whom two (2) clients can be non-ambulatory, but none may be bedridden. Only Bedroom #2, per the facility sketch, is approved for non-ambulatory clients. Per LPA observation, LIC602 Physician’s Reports, and interviews: During today’s inspection, there were a total of five (5) clients in care [Client #1 (C1) through Client #5 (C5)], of whom four (4) were ambulatory and one (1) was non-ambulatory. The non-ambulatory client resided in Bedroom #2, as required.

LPA interviewed multiple staff and multiple clients. LPAs also reviewed the care records for all clients, and the personnel and training files for all active staff. LPA, accompanied by Licensee, toured the interior and exterior of the facility and inspected all common areas and bedrooms.

During the facility tour, LPA observed: Inside one non-locking drawer was one (1) sharp cooking knife with a blade longer than six inches, and one (1) pair of sharp cooking shears. In another non-locking drawer was one (1) pesticide product. Inside one bedroom was one (1) medicated prescription cream, unlocked and in plain view. (Per records, the two residents who occupied this bedroom were determined by their respective physicians as not able to safely store medications.) [CONTINUED ON LIC 809-C, 1 of 2]