Facility Evaluation Report

On 05/10/2024 at 9:49 AM, Licensing Program Analyst (LPA) Avelina Martinez made an unannounced visit to this facility to conduct an annual required inspection. LPA Martinez met with Alex Archangel, Joseph Navarro, and AJ Land and explained the purpose of the visit. LPA Martinez inspected the physical plant including but not limited to the kitchen, dining room, resident bedrooms; resident bathrooms, laundry room, activity room, and outside courtyards of the facility to ensure compliance with Title 22 regulations.

Administrator holds current certificate, The facility is licensed for 15 ambulatory clients. There are currently 15 clients who reside at this facility.

The LPA Martinez toured the facility with AJ Land on 05/10/2024 at 12:10 PM.

LPA Martinez reviewed eight client files and eight staff files, and the files were maintained. The Last fire drill was on May 01, 2024 and emergency disaster drill was conducted on May 02, 2024. The facility has a natural disaster plan, an emergency preparedness plan, and an infection control plan. LPA Martinez reviewed two PNI ledgers, and the documents were maintained. LPA Martinez reviewed two medication administration records, and both were maintained. Requested documents received during today's visit were the following: liability insurance and surety bond. The bacteriological analysis annual inspection is due in October of 2024.

The facility has an adequate food supply, and the dinning area and kitchen were sanitary. The facility laundry room was sanitary, and toxins are stored in a locked room. Moreover, common areas, bedrooms, and bathrooms were furnished and sanitary. The fire extinguishers are in good repair.

As a result of this annual inspection visit, there were no deficiencies cited. An exit interview was conducted, and a copy of this 809 report was provided to the facility at the end of the visit.