Facility Evaluation Report

Licensing Program Analyst (LPA) Marcela Yanez conducted an unannounced Required 1 Year visit and met with Erene Bautista, Designated Administrator (DA). LPA announced the purpose of the visit. LPA observed 3 staff and 6 residents. The facility has a fire clearance for 6 bedridden and a hospice waiver granted 6

During visit, LPA toured the facility inside and out. LPA observed food storage areas and locked cabinets for cleaning supplies. LPA observed the kitchen area and observed locked cabinets for medications, sharp objects, and cleaning supplies.

LPA observed perishable food supply of at least two days and a non-perishable food supply of at least seven days. Refrigerator temperature measured with thermometer at 40 Degrees F.

LPA toured six resident bedrooms. Each bedroom had available bedding and clothing storage areas as well as functioning lights.

Staff tested the smoke detector in the hallway and found the smoke detector to function properly when tested. LPA toured one resident bathroom. Bathroom had available soap and paper towels and functioning lights. The water temperatures in the bathroom sink measured with thermometer at 118.4 F.

LPA observed a designated laundry area and 4 staff bedrooms.