Facility Evaluation Report

Licensing Program Analyst (LPA) Simi Rai conducted an unannounced Required 1 Year visit and met with Lead Caregiver, Oliver Antipala. LPA Rai observed 2 staff and 6 residents at the facility.

During visit, LPA Rai toured the inside and outside of the facility. When touring the outside area of the facility, the exits were cleared of obstruction. LPA Rai observed 1 shed that were used for storage and not as habitual space. LPA Rai toured the facility kitchen and observed food supply of at least 2 days of perishable food and at least 7 days of nonperishable food. Sharps and medications were locked in secured areas. LPA observed additional food supply areas and secured areas for cleaning supplies and laundry detergents.

LPA Rai toured the resident bedrooms. 3 out of 3 resident bedrooms had available bedding, drawers, and functioning lights.

The facility bathroom had available soap, paper towels, and trash cans with lids. The water temperature in 1 out of 2 bathroom sink was observed at 110.1 degrees F. The second bathroom was occupied during visit. The water temperature in the kitchen sink was 113.7 degrees F.

Fire extinguisher was observed and inspected on 8/11/2023. Facility smoke detectors and carbon monoxide detectors were in working condition. The last disaster drill was conducted on 3/29/2024.

LPA Rai reviewed facility records for 3 staff and 3 residents. LPA Rai reviewed resident medications and central stored medication records.

No deficiencies were cited per California Code of Regulations, Title 22. This report was reviewed with Lead Caregiver, Oliver Antipala and a copy of the report was provided.