Facility Evaluation Report

Licensing Program Analyst (LPA) Christine Kabariti arrived unannounced to conduct a case management – incident visit. LPA met with Administrator, Leofelma Miranda.

On 04/03/2025, the Department received an incident report from resident (R1)’s day program regarding the observation of mold inside R1’s reusable water bottle. Photographs of R1’s water bottle was obtained by the day program, which shows black mold inside the water bottle and mold around the rim and cap of the water bottle.

During today’s visit, LPA toured the facility to include the kitchen, resident bedrooms, and common areas. LPA interviewed the Administrator, it was stated that R1 normally gets his own water from the refrigerator and occasionally have staff help. ADM was unsure if staff was washing R1's water bottle daily as R1 was handling refilling his own water bottle. It was stated that after the incident was reported to the facility they immediately purchased R1 a new water bottle. ADM states that going forward, they have all the residents leave their reusable water bottles next to the sink after day program for staff to wash daily. ADM states R1 was sent to the hospital sometime in March due to another reason. ADM states they checked all remaining residents water bottles to ensure they are safe to use and sanitary.

A deficiency was cited per California Code of Regulation, Title 22. See LIC809-D. This report was reviewed with Administrator, Leofelma Miranda and a copy of the report and appeal rights were provided.