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 Administrator Timothy "TJ" Carrasco. LPA also met with Licensee Liberty Cruz Nelson, who arrived shortly after.
According to the facility’s license, the facility has a maximum capacity of six (6) clients, of whom all must be ambulatory. According to LIC602 Physician’s Reports, staff interviews, and LPA observation: During this annual inspection, there were a total of five (5) clients in care, of whom all were ambulatory, per their respective doctors. The facility’s license did not include endorsements for delayed-egress doors or secured perimeter, and neither of these were present.
During this inspection, LPA interviewed multiple clients and staff. LPA reviewed the care and administrative records for all clients and the personnel and training files for all active staff. The files reviewed were complete/complaint. LPA also toured the interior and exterior of the facility and inspected all common areas and bedrooms. In the facility’s kitchen, LPA observed unlocked/unsecured: one (1) sharp cooking knife with an approximately eight-inch metal blade, and one (1) pair of sharp scissors. In the facility’s backyard, LPA observed unlocked/unsecured: one (1) large spade tool with a rusted metal blade that was roughly eight-inches long by eight-inches wide, and one (1) loose piece of rusted metal rebar around 1.5 feet long.
The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, windows and screens, toilets, and showers were working. Extra linens, hygiene, and Personal Protective Equipment (PPE) supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction