Facility Evaluation Report

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced annual inspection visit, and met with Administrator (ADM) Linda Arciaga. Upon arrival, staff Remedios Floresca (RF) took LPA body temperature, asked the infection control questionnaires, and checked LPA in the visitor log book.

LPA toured the facility inside out with RF. COVID posters were observed at main entrance and the facility. ADM stated the facility will put more new COVID posters on in facility. Screening station with masks, hand sanitizer, glove, thermometer and visitor log book was observed at the main entrance. Family room, kitchen, dinning room, office and two restrooms were inspected. Some trash cans were observed without covers. ADM stated the facility will replace with trash cans with covers in two days. No Paper towel in kitchen was observed. Cloth towels were observed in kitchen. RF removed the cloth towels in kitchen, and placed paper towels with holders in kitchen. Two single resident bedrooms, two resident shared rooms and laundry area were inspected. Two staff live-in rooms are in facility. Medication closet, knives closet, and cleaning product closet were observed locked. Room temperature was at 69 degree F, and hot water temperature was at 108 degree F in facility. 3 residents and 3 staff were observed in facility.

Fire extinguisher was serviced on 12/27/2021. The facility was equipped with fire alarm system, smoke and carbon monoxide detectors. Smoke detectors was tested by RF, and were working fine. Front yard and backyard were inspected. There was no obstruction to block the walkways.

ADM stated all the residents and staff are fully vaccinated and done with booster. No citation were noted today. Exit interview was conducted with ADM. This report was provided to ADM for signature.