Facility Evaluation Report

At 8:00am on 01/12/2025, Licensing Program Analyst (LPA) Jeffries arrived to the facility unannounced to conduct the annual facility inspection. LPA met with Licensee/Administrator Lita Lazo announced who he is and the reason for the visit.

LPA noted that this is a 7 bedroom, 3 bathroom, single resident occupancy bedrooms and 1 staff room (room#5), there are 2 living rooms, a dining room, kitchen and laundry room. the garage is a converted storage area. There is seating and shade both in the back yard and the front yard with shade for resident activities and visitations. LPA noted that each room has proper furnishing, linins, and lighting. LPA noted that the bathrooms have liquid soap and paper towels and water temperature tested throughout the facility is within regulation permitters of 105*-120*(f). LPA observed at least 2 days of perishable foods and 7 days of non permeable foods on hand for at least 6 residents and staff. LPA discovered expired food in the freezer and noted a "rotting" smell in the dining room. Citation and civil penalty issue for repeat violation for less than 12 months (87555(b)(8)). LPA noted that the emergency water supply is located in the garage storage area. LPA noted that the medications are locked in the dining room and there is a complete first aide kit also located with the medications. LPA noted that there are smoke detectors located throughout the facility and carbon monoxide detector is located in kitchen doorway. LPA noted that the facility is clean and in good repair. LPA observed fire extinguishers primed and in the green and currently tagged as working. LPA observe all door ways and passage ways to be free and clear of obstacle. LPA noted that required postings are in the kitchen and hallways of the facility. LPA conducted a review of Emergency Disaster Plan, Infection Control Plan, Staff and Resident Files and a cursory review of Centrally Stored Medication Records (CSMR).

Administrator/Licensee and LPA conducted a full review of the annual care tools module and noted one violation and civil penalty issued for repeat violation with in 12 months.

Exit interview, report read, violation and civil penalty issued, appeal rights and report provided.