Facility Evaluation Report

Licensing Program Analyst (LPA) Dang Nguyen conducted 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 Jovita Caniya. LPA then met with Supervisor Pia Abille, who arrived later during the visit.

According to the facility’s license, the facility has a maximum capacity of six (6) clients, of whom all must be ambulatory. Per LPA observation, LIC602 Physician’s Reports, and staff interview: During today’s inspection, there were a total of six (6) clients in care, and all were ambulatory. LPA interviewed multiple staff and multiple clients who were present. LPA also reviewed the care records for all clients, and the personnel files for multiple staff.

During the facility tour, LPA observed: The facility did not have a carbon monoxide detector, as required. When measured with thermometer, hot water temperature at taps accessible to clients were too hot: Kitchen Sink was 134.4 F, Bathroom #1 Sink was 138 F, and Bathroom #2 Sink was 133 F. (Regulation requires taps used by clients to be between 105 F and 120 F when turned to hot.) Bathroom #1 had no working lighting. Manager interview confirmed that this was not due to the missing ligh tbulb in the overhead fixture, but rather the overhead fixture not having working electricity, which Licensee has been aware of for at least a week but had not yet called in an electrician for. (Electricity in other parts of the facility was working.) LPA observed dust and cobwebs on some walls, surfaces, and floors of common areas; this topic also came up during a client interview.