Facility Evaluation Report

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced annual inspection visit, and met with Administrator (ADM) Debbie Cota.

ADM informed that 45 residents and 20 staff in the facility. LPA reviewed 5 resident files and 5 staff files.

LPA toured the facility with ADM. Lobby, common area, activity room, kitchen, dining room, laundry room, salon room, break room, storage room, and restrooms were inspected. 29 shared resident bedrooms were inspected. 2 bedrooms shared with one restroom and 1 single room with restroom, 3 common shower rooms and common restrooms were inspected. Two day perishable food supplies and seven day nonperishable food supplies were observed sufficient. The temperature of refrigerator was observed at 40 degree F and the temperature of the freezer was observed at -5 degree F. Medication room was observed locked. Cleaning product room was observed locked. Room temperature was at 73 degree F, and hot water temperature was at 106 degree F in facility.

The fall prevention alarm system was tested and was working. First aid boxes were observed in the facility.

Fire extinguisher was serviced on 9/24/2024. The facility was equipped with fire alarm system, smoke and carbon monoxide detectors. carbon monoxide detector were tested and were observed working. The courtyard and backyard were toured. The last time the facility conducted the fire drill was on 6/12/2025. ADM stated the facility conducts fire drill every quarter.

No citation were noted today. Exit interview was conducted with ADM. This report was provided to ADM for signature. A copy of the reports was provided to ADM.