Facility Evaluation Report

Licensing Program Analyst (LPA) Robert Campbell conducted an unannounced annual required visit. Upon entry, LPA were greeted by Jocelyn Estepa, Caregiver, and informed them of the purpose of the visit. At the time of the visit, there was one (1) staff member and three (3) residents present. Stan Estepa/Administrator, came out of a room later during the visit.

Facility Overview: The facility is a one-story home with five (5) bedrooms and three (3) bathrooms, including an attached garage. There are no pools or known firearms on the premises.

Infection Control: LPA observed that hygiene and cleaning supplies were available for regular facility maintenance. The facility has infection control plan in file.

Physical Plant: The physical plant, including floors, windows, and doors, was clean and well maintained. Fixtures and furniture were in good repair. Laundry equipment was in good working condition. Sharp and dangerous objects were securely locked and inaccessible to residents. Both the smoke detector and carbon monoxide detector were operational, and the hot water temperature was 110°F. Fire extinguisher located at kitchen. LPA observed outside a lot of debris that needs to be thrown away detailed in the LIC809D form.

Food Service: The facility’s kitchen was clean and equipped to prepare food. The facility maintained the required two-day supply of perishable foods and a seven-day supply of non-perishable foods.