Facility Evaluation Report

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced annual inspection visit, and met with Administrator (ADM) Christia Mendoza Vasquez . LPA observed 3 staff in the facility, and all the residents went to day program.

LPA reviewed 3 resident files and 3 staff files. LPA toured the facility inside out with ADM. License, ADM certificate and Personal rights posters were observed in the facility. Living room, kitchen, dinning room and two restrooms were inspected. 3 resident bedrooms, and laundry room were inspected. Two staff live-in rooms was observed in facility. One storage room was observed in the garage. One staff live-in room was observed in the garage. ADM change the room back to storage room immediately. The temperature of the freezer in the kitchen was observed at 30 degree F. The refrigerator in the kitchen was observed not cool enough. ADM stated the facility has a backup refrigerator in garage. ADM stated the facility is planing to replace the refrigerator in the kitchen with a new one. Medication closet, knives closet, and cleaning product closet were observed locked. Room temperature was at 77 degree F, and hot water temperature was at 108 degree F in facility. First Aid box, Flash lights and night lights were observed in the facility. The last time the facility conducted the emergency drill is 4/7/2024.

Fire extinguisher was serviced on 03/19/2024. The facility was equipped with fire alarm system, smoke and carbon monoxide detectors. Smoke detectors was tested by ADM, and were working fine. Front yard and backyard were inspected. There was no obstruction to block the walkways. One storage room was observed in the back yard.

Deficiencies noted today. See LIC809-D. Exit interview was conducted with ADM. This report was provided to ADM for signature.