Facility Evaluation Report

Licensing Program Analyst (LPA) Christine Dolores arrived unannounced to conduct the facility's Required - 1 Year annual inspection. LPA met with Interim Administrator, Jocelyn Canosa.

During visit, LPA toured the facility to include the living rooms, kitchen, resident bedrooms, bathrooms, and exterior. LPA observed 2 residents. 2 staff members (1 LVN and 1 PT) were present and 1 respiratory therapist present only during the beginning of the visit. The 3 staff members are fingerprint cleared and associated to the facility's roster. During visit, a musician arrived to the facility to play music for the residents.

All fire exit routes are free and clear of obstruction. Fire extinguisher last serviced on 01/19/2024. Facility has an operable carbon monoxide detector. The facility has a Central Fire Alarm System that is connected to a monitoring vendor which will alert the local fire department in the event of an emergency. The fire alarm system was last serviced on 11/14/2023. The facility has overhead lifts in the resident bedrooms, bathrooms and in one of the living room area. Facility has an emergency disaster plan last updated on 10/01/2023 which still lists the former Administrator. LPA advised the Administrator to review and update the emergency disaster plan. Fire/Earthquake drills are being conducted at least quarterly. LPA observed 2 out of 2 residents uses oxygen. Facility has a back-up generator which was last serviced on 09/09/2024. Facility staff tests the generator weekly for about 15 minutes to ensure it is operable.

Facility temperature maintained at 70 degrees F. Lidded trash bin observed in the kitchen. See LIC809-C for additional information.