Facility Evaluation Report

Announced Prelicensing visit made out to this facility on 06/17/2024 by Licensing Program Analyst (LPA) Charlie Yang who was met by the facility Applicant, Anabelen Vallarta, at this time. A brief interview was conducted with the facility Applicant at this time.

It was learned that this facility was seeking licensure to be able to accept/retain up to (6) residents at any given time.

This facility was seeking licensure for (3) non ambulatory and (3) ambulatory residents with a hospice waiver granted for (2) residents at any given time.

A tour of the facility kitchen area was conducted. Drawers and cabinets were opened and the items enclosed were reviewed at this time. Drawers housing knives and sharps were observed to be locked and made inaccessible to the residents at this time.

Cleaning agents, bleach, and other supplies were observed to be locked and made inaccessible to the residents at this time.

A review of the facility food supply was conducted. A review of the facility's 2-day perishable foods and 7-day nonperishable foods was conducted to make sure that there were sufficient quantities on hand at all times.

Medication cabinet, located in the hallway closet, was reviewed. Policies and procedures involving, dispensing, and documentation of the resident medications were discussed with the facility Applicant at this time. A review of the facility Medication Administration Record and dispensing log was conducted.

Medication cabinet was observed to be locked and made inaccessible to the residents at this time.

Living room, dining area, and all other areas intended for resident use were observed to furnished and maintained in compliance at this time and able to meet the needs of the residents.

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