Facility Evaluation Report

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced annual inspection visit, and met with administrator (ADM) Jocelyn Real. Upon arrival, ADM took LPA body temperature, 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. Four residents were observed in facility. Three shared resident bedrooms, and two bath rooms were inspected. Trash cans were observed with covers. 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 72 degree F. Hot water was observed at 108 degree F.

Fire extinguisher was serviced on 04/18/2022. 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 done the booster shots. ADM already submitted Infection Control Plan to LPA.

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