Facility Evaluation Report

On June 19, 2025, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced annual visit. LPA met with Administrator, Eloisa Bustamante and explained the purpose of the visit.

LPA toured the facility inside and outside including all of resident rooms, common areas & kitchen. The indoor and outdoor passageway was free of obstruction. No accessible bodies of water of fire safety hazards observed. This is a single story facility. LPA observed a random sample of resident rooms and observed required furniture. LPA observed 2- days perishables and 7- days of non-perishables. Toilet, hand washing and bathing areas were observed clean and odor-free. Shower room was observed equipped with non-skid mats and grab bars. Comfortable temperature is maintained and lighting is sufficient for comfort. Extra linen was observed present. Medications, sharps and chemicals were observed to be locked and inaccessible to residents in care. Water temperature throughout the facility measured between 105-119 degrees F.

Hot water temperature in the kitchen and bathroom were measured at 108-117 degrees Fahrenheit. Fire extinguishers were checked and last inspected on 4/22/2024. Dining room was observed free from tripping hazards. Carbon monoxide monitors are working properly. All fire extinguishers have been checked and current as of April 2025. LPA reviewed 5 resident records and 4 staff records. Resident records are updated, complete and signed. Staff records have training logs that have met the basic requirement. Medication review was done, and all medications are accounted for, and centrally stored medication records are updated.

Based on observation, deficiency is cited under California Code of Regulations, Title, 22 cited on the LIC 809D. Failure to correct the deficiencies may result in civil penalties. Report is reviewed with Administrator and a copy is provided.