Facility Evaluation Report

On 8/24/22 at approximately 2:40pm Licensing Program Analyst (LPA) Maja Jensen arrived at facility unannounced to conduct a post-licensing visit. LPA Jensen met with Licensee Guadalupe Yepiz and explained the purpose of today's visit.

LPA Jensen toured the facility including but not limited to kitchen, dining room, 2 bathrooms, 4 bedrooms, laundry room, garage and grounds.

The facility was observed to be sanitary and free of odor. The grounds were landscaped and free of obstruction. There are no bodies of water on the property. The facility was 77 degrees which falls within the required range of 68-85 degrees. The water temperature in the kitchen was measured at 111 degrees which falls within the required range of 105-120 degrees. The fire extinguisher was last serviced in October of 2021 and is in compliance. The emergency disaster plan was reviewed and is in compliance. LPA Jensen discussed use of the Everbridge Application with Licensee. The facility keeps a supply of PPE in excess of 30 days. Carbon monoxide detectors in the facility were observed to be in good repair. The hallways were equipped with night lights.

There was 2 days of perishable food and 7 days of non-perishable food on hand. Fresh fruit including bananas, melons, and citrus fruit is available and accessible by residents. An adequate supply of linens is available for residents in care. The medications and toxins were observed to be locked and inaccessible to residents.

LPA Jensen interviewed 1 of 1 resident. See LIC 812. LPA Jensen reviewed 1 of 2 staff files and 1 of 1 resident files.