Facility Evaluation Report, 01/25/2023 — Burnham Court Care Home, Stockton CA

Licensing Program Analyst (LPA) Michael Bilger, conducted an unannounced Pre-licensing visit on 1/25/23 with applicant Tropy Asuncion of Tropics Manor, Inc.. LPA arrived at facility at 2:39pm . Applicant and Administrator accompanied LPA on facility tour. This facility is currently licensed with LIC. #397001803 and applicant is seeking licensure through change of ownership process. As of today, current census is 6 residents of which 0 are Hospice, 6 are ambulatory, 0 are non ambulatory, and 0 are bedridden. The facility is a 5 bedrooms, 2.5 bath house with a living room, dining room, and laundry room. Residents have access to all areas. 4 of 4 staff records reviewed with criminal record clearance association in place. 6 of 6 resident files reviewed. All required contents in place. Fire clearance is approved for 6 ambulatory residents.

Upon entry, LPA’s temperature was taken and LPA signed the visitor log. LPA was screened for COVID signs and symptoms questions. Facility sketch posted and visible. Food supply is adequate with 7 days of non-perishables and 2 days of perishables on hand. All bedrooms and common areas contained appropriate furnishings. Adequate amounts of linen were in place, accessible, and located in hallway linen closet. LPA measured the hot water in the kitchen faucet and hallway bathroom and are within regulatory range of 105*F and 120*F. LPA observed kitchen knives locked and secured. Smoke detectors and carbon monoxide detectors are in good repair. Facility temperature was 71*F. COVID-19 mitigation plan and current disaster plan in place.

LPA observed medications locked and properly stored with first aid kit available and stocked. COVID precautions in place including signage, PPE storage and 30-day supply observed. LPA observed no obstruction of emergency exits. Fire extinguisher in place in kitchen and fully charged with last inspected 4-18-22. No deficiencies cited during visit. An exit interview was conducted with Ruby Escorido and Tropy Asuncion and a copy of this report was provided to Tropy. Component III completed with Licensee and Administrator.