Facility Evaluation Report

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced annual inspection visit, and met with administrator (ADM) Jocelyn Real. Upon arrival, staff Mercedes Lazaro (ML) took LPA body temperature, asked the infection control questionnaires, and logged LPA in the visitor book.

LPA observed the COVID posters at main entrance and in facility. A screening station with face masks, hand sanitizers, gloves and visitor log book was observed at main entrance. Living room, kitchen, and family room were inspected. Two residents were observed in facility. Four residents were out for day program. Three shared resident bedrooms, and two bath rooms were inspected. Not all the trash cans are with covers. ADM stated the facility will fix this issue in 3 days. Two day perishable food supplies and seven day nonperishable food supplies were observed sufficient. Knives closet, cleaning product closet, and medication closet were observed locked. Room temperature was observed at 73 degree F. Hot water was observed at 108 degree F. PPE supplies were observed sufficient. LPA suggest to make medication closet lock stronger, to put more paper towel with holders in facility.

Fire extinguisher was serviced on 04/30/2021. The facility was equipped with smoke and carbon monoxide detectors, and fire alarm. Front yard and backyard were inspected. There was no obstruction observed to block the walkways.

ADM stated all the staff and residents are fully vaccinated and have the booster shots.

No deficiency or citation were noted today. Exit interview was conducted with ADM. This report was provided to ADM for signature. A copy of this report was emailed to ADM.