Facility Evaluation Report

On 01/30/2024, Licensing Program Analyst (LPA) Brian Phillips arrived unannounced for an unscheduled visit to conduct a required Annual site inspection visit at the facility above. When the LPA arrived, they were greeted by Administrator Valentina Roberts, and informed them of the reason for the visit.

The LPA toured the physical plant areas inside and outside to ensure there are no health and safety hazards and the facility is in compliance with Title 22 Regulations. This is a Residential Care Facility for the Elderly (RCFE), with an approved fire clearance capacity of six (6) residents. The facility is approved for six (6) non-ambulatory residents, of which six (6) may be bedridden. The facility has an approved Hospice Waiver for four (4) residents. The physical plant of the facility contains a living room, family room, kitchen, dining room, Staff room, breakfast area, office room, laundry room area, garage, and six (6) private resident bedrooms available for individual residents with no shared bedrooms. There are three (3) restrooms within the facility, all containing both toilets and bathtub/shower. The facility contains an outside area for residents to utilize for outdoor activities/outdoor visitations with a shaded outdoor covered patio area appropriately furnished for outdoor use.

KITCHEN: The LPA inspected the kitchen/food service area and observed that knives/sharp instruments are stored in a locked drawer inaccessible to residents. Kitchen appliances were in operable condition and looked clean/in good repair. The LPA observed perishable items in good condition, with proper expiration dates precluding the perishable items from expiring. The facility has a sufficient supply of perishable and non-perishable food, which would last over a week (7 days). Additional perishable food items were maintained in a pantry storage area in the of the facility. The facility stores extra perishable and non-perishable food in the garage of the facility with cabinets of food, an extra refrigerator and extra freezer located in the garage area of the facility. The hot water temperature was measured in the kitchen at 100 degrees Fahrenheit, a level slightly below the appropriate temperature as per the regulation between 105-120 degrees Fahrenheit. Continued 809-C