Facility Evaluation Report

On 2/15/2023, Licensing Program Analyst(LPA) Murial Han conducted an unannounced annual inspection. LPA observed COVID-19 signs posted by the entrance. LPA was greeted and screened by the administrator, Imeda Prado. LPA explained the purpose of the visit.

LPA toured facility and grounds. No accessible bodies of water or fire safety hazards observed. Infection control practices are reviewed: entry procedures, staff training and policies, resident and staff daily monitoring records, containment strategies. There are 6 residents at the facility and 2 present during the inspection; the other residents are either at adult day program or medical appointment. There are 2 private rooms and 2 shared rooms with beds observed to be 6" apart. PPE supply and the environmental cleaning supply are adequate, bathrooms are equipped with liquid soap and paper towels, hand washing instruction is posted by the hand washing stations. Trash cans are observed to have foot operated close lids.

The facility appeared to be cleaned and tidy. Medications, toxins and sharps are stored appropriately and inaccessible to resident, a comfortable temperature is maintained, lighting is sufficient for comfort and safety and food supply was checked and observed to be sufficient. First-aid kit is inspected and complete.

During today's inspection, LPA Han obtained a copy of administrator certification, LIC610D, and LIC500.

This report is reviewed and discussed with the administrator. A copy is provided.