Facility Evaluation Report

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced annual inspection, and met with Administrator (ADM) Jocelyn Perez.

Upon Arrival, ADM took LPA's body temperature, and checked LPA in the visitor log book. LPA observed the COVID posters in the facility.

LPA toured the facility with ADM inside and out. LPA inspected living room, dinning area, family room and kitchen. There are 2 restrooms, 1 staff live-in room, and 3 resident rooms in facility. The beds in the shared rooms were observed 6 feet apart. Trash cans was observed with covers. There were no posters of washing hands for 20 seconds by the sinks in restrooms and kitchen even though posters of washing hands were observed. ADM stated the facility will put posters of washing hands for 20 seconds by the sinks in restrooms and kitchen within 3 day. Two days perishable foods and seven day nonperishable foods were observed sufficient. PPE supplies were observed sufficient. Room temperature was observed at 72 degree F, hot water temperature was observed at 110 degree F. Medication cabinet, Knife closet were observed locked. Cleaning products closet was observed locked. The facility was equipped with smoke and carbon monoxide detectors. Smoke detector alarm system was tested, and was working fine. Fire extinguisher was serviced on 7/9/2022. 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 shots. ADM stated the facility submitted the Infection Control Plan to CCL office.

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