Facility Evaluation Report

LPA Kesha Lewis made an unannounced health and safety check. LPA met with Staff. LPA explained the purpose of the visit to conduct a health and safety check of the facility. The facility had recently been with out Power.

Incident from 1/03/2023. LPA was informed that the facility has been without power since 12/31/22. The facility was informed by PG&E that a tree had fallen on the power line and disrupted service to the area. The facility has relocated to The La Qunita Inn located in Stockton. There are five residents in three rooms.

Residents returned to facility on 01/05/2033 at approximately 10:00AM. LPA observed staff on duty and some residents using the activity area to watch TV. LPA toured the facility. The facility room temperature was measured at (71) degrees. Water temperature in bathroom was measured at 110 degrees. LPA checked for medications, food/snacks and resident files.

Health and Safety check included overall safety of the facility including food supply, physical plant and staffing. The facility has a sufficient 2 day supply of perishable food and 7 day non perishable food.

Deficiencies are being cited from the incident on 01/03/2023 pursuant to Title 22 rules and regulations, Health and Safety Codes. Exit interview conducted and a copy of the report left at facility.