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 Administrative Assistant Jasmine Ybarra. LPA then met with Administrator Susan O’Shaughnessy, who arrived shortly after.

According to the facility’s license, the facility has a maximum capacity for one-hundred-ten (110) residents, of whom all may be ambulatory or non-ambulatory, and up to ten (10) may be bedridden. Also, up to twenty (20) of the residents may be under hospice care at any given time. Per LPA observation, LIC602 Physician’s Reports, and manager interviews: During today’s inspection, there were a total of forty-nine (49) residents in care, of whom thirty-four (34) were non-ambulatory, and one (1) was bedridden. Also, eight (8) of the residents were under hospice care. The facility’s license and fire clearance allowed for the use of locked perimeter doors in the memory care unit, and such doors were compliant with this stipulation.

LPA reviewed records for multiple residents and multiple staff. LPA interviewed multiple staff. LPA, accompanied by the administrator, also toured the interior and exterior of the facility, and inspected all common areas and multiple resident rooms. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Doors, windows and screens, toilets, and showers were working. Extra linens and hygiene supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities. The facility’s ambient internal temperature was complaint at 75 F. [CONTINUED ON LIC 809-C, 1 of 2]