Facility Evaluation Report

Licensing Program Analysts (LPA) Melina Oropeza arrived at this facility unannounced to conduct a Required 1 Year Annual Inspection Visit. LPA was met by staff and administrator joined 40 minutes later. LPA explained the purpose of the visit to Administrator and staff. Administrator, Juliet Ramones certificate #7015643740 expires 04/02/2028. The facility is licensed for 6 non-ambulatory, of which 1 may be bedridden, approved hospice for 6 residents. Current census is 5. Currently, 4 residents are non-ambulatory and 1 resident is bedridden. The facility has a program to be able to accept and retain dementia residents at any given time. The 5 residents are diagnosed with dementia at this time and 1 resident is hospice.

LPA and administrator inspected the physical plant including but not limited to the kitchen, dining room, resident bedrooms; resident bathrooms, laundry area, living area and other common areas, as well as outside of the facility to ensure compliance with Title 22 regulations. There is entry door is leading to the living room, kitchen with a hallway to the bedrooms and bathrooms. Chemicals were noted to be locked under the kitchen sink and made inaccessible to residents in care. Medication cabinet, located in the facility hallway, was observed to be locked and made inaccessible to the residents at this time

LPA also conducted the care domain tool. No bodies of water were observed at the facility.

Hot water temperature was measured at 106 F degrees Fahrenheit in resident bathroom sink, which is within the required range of 105 to 120 degrees Fahrenheit. Toured two residents bathrooms. Grab bars and non skid mats were observed to be present and in good repair at this time. All necessary documents were in place. LPA observed the following posted on the facility wall: Facility license, sketch, See Something Say Something poster, Ombudsman poster, Theft and Loss Policy, Resident Bill of Rights, Rights of Resident/Family Councils.