Facility Evaluation Report

Licensing Program Analyst (LPA) Manuel Monter conducted an unannounced annual inspection visit, and met with Administrator (ADM) Thuy Tran. LPA explained the purpose of the visit.

LPA toured the facility inside out with ADM which included; the Living room, kitchen, dinning room, garage, two restrooms, staff room and 3 residents bedrooms. Front yard and backyard were inspected. There was no obstruction to block the walkways.

While touring the residents bedrooms, LPA observed 2 windows without screens in bedroom 3. ADM stated one of the residents has a behavior of pushing objects thru the window and pushing the screen as well. ADM stated she has notified SARC as well about this. LPA observed the window in bedroom 2 with a damaged window screen as well.

Two day perishable food supplies and seven day nonperishable food supplies were observed. LPA observed the medication cabinet, knives storage area, and cleaning product storage area as locked and inaccessible to residents in care. Room temperature was at 75 degree F, and hot water temperature was measured at 108 degrees F in the upstairs bathroom and 106 degrees F in the downstairs bathroom. Fire extinguisher was serviced in September 2023. The facility was equipped with smoke and carbon monoxide detectors. Smoke detectors was tested by ADM, and were functional. LPA observed facility first aid kit and facility fire/earthquake drill log. The facility's last drill was on 09/21/2023.

LPA reviewed facility records for 3 staff and 3 residents. LPA reviewed 3 resident medications and centrally stored medication records. LPA conducted interviews with 2 staff (S1 to S2) and 2 residents (R1-R2).

Deficiencies are being cited during today's visit. See LIC809D. This report was reviewed with Administrator Thuy Tran and a copy of the signed report was provided.