Facility Evaluation Report

On 10/12/2023, Licensing Program Analyst (LPA) Brian Phillips arrived at the facility unannounced to conduct an Annual facility Site Inspection Visit. LPA met with Administrator/Licensee Alan Flojo, and announced the purpose of the visit.

The LPA toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. This is a Residential Care Facility for the Elderly (RCFE) consisting of 8 bedrooms, (6 designated resident single rooms, 2 staff rooms) 3 restrooms, a kitchen, dining room, 2 living rooms, 1 Central Medication area (where medications are centrally stored and locked), laundry room, Staff office area, and multiple storage room areas. This facility is approved for a maximum of six (6) non-ambulatory residents, and has a hospice waiver for four (4) residents.

KITCHEN: The LPA inspected the kitchen/food service area and observed that knives/sharp instruments are stored in locked drawers 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 storage area in the garage of the facility as well as in extra refrigerator and extra freezer located in the garage of the facility. The hot water temperature was measured in the kitchen at an appropriate temperature as per the regulation between 105-120 degrees Fahrenheit. Items that could constitute a danger to residents are kept inaccessible to residents in the kitchen area. The kitchen was clean and sanitary, with covered trashcans and operating ventilation systems. No toxic substances are stored in any food preparation or storage area, and all cleaning supplies for the kitchen are kept in a separate area than the food supplies. The freezer and refrigerator were both in the appropriate temperate Fahrenheit. There is enough tableware and utensils for all residents living in the facility, and enough equipment for the storage, preparation, and service of food. The facility cooks meals for the residents on a regular basis.

COMMON AREAS: At the time of the visit, the common areas of the facility (dining room, 2 common room areas) were observed to be appropriately furnished, with all furniture in good condition. Contd. on 809-C