Facility Evaluation Report

Unannounced Post Licensing visit made out to this facility on 12/13/2023 by Licensing Program Analyst (LPA) Charlie Yang who was met by the facility designated Administrator Ricky Nolasco. A brief interview was conducted with the facility designated Administrator at this time.

It was learned that there weren't any residents under the care of hospice at this time.

This facility does have a hospice waiver to be able to accept and retain up to (2) hospice residents at any given time.

It was learned that there weren't any residents receiving any care from a home health care agency at this time. It was learned that there weren't any residents diagnosed with dementia at this time.

Administrator certificate was observed to be present and in compliance at this time for facility designated Administrator Ricky Nolasco. Additional forms and documents were reviewed to make sure that the renewal process was initiated prior to the certificate expiration date of 09/28/2024 with certificate # 6057310740.

Kitchen area was toured. Cabinets and drawers were reviewed.

Food supply was reviewed for adequate 2-day perishable and 7-day nonperishable quantities at this time. A tour of the dining area, living area, and all other areas intended for resident use was conducted.

Medication cabinet, located in a separate room, was reviewed. Policies and procedures involving dispensing, documenting, and overall administration of resident medications was discussed with the facility designated Administrator at this time. This medication cabinet was observed to be locked and made inaccessible to the residents at this time.

A tour of the resident bedrooms and restrooms was conducted. Furniture and furnishings were observed to be sufficient and able to meet the needs of the residents at this time.

Hot water temperatures were taken and measured to make sure that they were within the allowed range of 105-120 degrees.