Facility Evaluation Report

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced annual inspection visit and met with Administrator (ADM) Jean Jose and Licensee (LCN) Gano Fici.

LPA reviewed 5 residents files and 5 staff files.LPA toured the facility inside out with ADM. Licensee, Personal Rights posters and Administrator Certificate were observed at the main entrance. Living room, family room, dining room, kitchen, 6 resident bedroom rooms, 3 restrooms, and laundry room were inspected. 2 staff and 6 residents were observed in the facility.

Two day perishable food supplies and Seven day nonperishable food supplies were observed sufficient. Room temperature was observed at 71 degree F. Hot water temperature was observed at 115 degree F. Refrigerator temperature was observed at 40 degree F. Freezer temperature was observed at 0 degree F.

All of the bedrooms were observed with window screens and in good repair. Fire extinguisher was serviced on 11/28/2023. The facility was equipped with fire alarm system, smoke and carbon monoxide detectors. Smoke detectors were tested by ADM, and were working fine. Medications closet was observed locked. Knives closet and detergent closet were observed locked.

One of the bathroom was observed without nonskid pad. The bedroom with resident using Oxygen administration was observed with the warning sign. First aid box was observed in the facility. Night lights were observed at the hallway. LPA toured the backyard with ADM. There were no obstacles blocked the exit.

The facility last fire and emergency drill was conducted on 10/7/2023.