Facility Evaluation Report

On July 31, 2024, Licensing Program Analyst(LPA) Murial Han conducted an unannounced annual inspection. Upon entrance, LPA was greeted by the caregiver, Maria Velasco and LPA explained of today's visit. The administrator, Monette arrived during the inspection and LPA explained the purpose of the visit.

LPA toured facility and grounds. No accessible bodies of water or fire safety hazards observed. LPA toured the facility inside and outside including all of resident rooms, common areas, and kitchen area. The indoor and outdoor passageways were free of obstruction. Facility was overall clean and odor-free. Comfortable temperature is maintained and lighting is sufficient for comfort.

LPA observed four shared rooms (3 rooms for residents and 1 room for staff). Rooms were spacious and included all required furnishings. Two full bathrooms were observed to be clean and in operating condition. Hot water temperature was measured at 106- 119 F.

LPA observed medications, toxins and sharps to be locked and inaccessible to residents in care. 2 days for perishables and & 7 days non-perishable were observed to be present.

A review of (5) resident files was conducted and noted on the LIC 858.

A review of (2) staff files was conducted and noted on the LIC 859.

LPA reviewed P& I records for 3 residents to be adequate.

LPA requested for documents to be submitted to CCL by 8/1/2024: LIC 400, Liability Insurance, proof of administrator certification renewal, and control of property/ lease agreement.

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