Facility Evaluation Report

Licensing Program Analyst (LPA) David Marrufo conducted an unannounced Required 1 Year visit and met with Program Director (PD) Linda Hitchcock. During visit, LPA toured the facility inside and out.

LPA observed the kitchen area to have locked cabinets for sharp objects and cleaning supplies.

LPA toured two out of two resident bathrooms. Each bathroom had working lights and available soap and paper towels. The water temperatures in the bathrooms measured at 107 F and 109 F.

LPA Marrufo reviewed the facility records and observed the last fire detector system inspection was conducted on 11/27/2024. Three out of three fire extinguishers had service tags dated May 2024.

LPA reviewed six resident records. Resident R1's record was missing an Admission Agreement and Physician's Report. LPA reviewed the staff records for staff S1-S4. S1 and S2 were missing first aid certifications. S3 and S4 had current first aid certifications. During visit, PD stated that either S3 or S4 are always on duty. LPA reviewed the staff schedule during visit. S2 was missing a health screening form.

There was no disaster drill log kept at the facility.

Deficiencies were cited as per California Code of Regulations Title 22. See LIC809-D pages for more information. This report was reviewed with PD Linda Hitchcock and a copy of this report was provided.