Facility Evaluation Report

Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced Required 1 Year visit and met with caregivers Cecilia Ansagay and Josephine Prado. LPA met with Ceclia primarily and explained the purpose of today's visit. Around 12:15pm the administrator Amparo Garcia arrived and met with LPA.

This is a single level facility licensed for 60 and over all of which may be non-ambulatory. Hospice waiver on file for 2 residents. As of today's visit, there is only 1 resident on hospice. During visit, LPA toured the facility inside and out. LPA toured the garage area and observed food storage areas and locked cabinets for cleaning supplies. LPA observed the kitchen area and observed locked cabinets for medications, sharp objects, and cleaning supplies. LPA observed perishable food supply of at least two days and a non-perishable food supply of at least seven days. Refrigerator is observed to be fully operational and functioning. There is an additional refrigerator in the garage for resident supplies as well. Laundry area is observed in the garage. Both washer and dryer are observed to be functioning and in operation during today's visit. LPA toured all resident bedrooms. Each bedroom had available bedding and clothing storage areas as well as functioning lights. Each room had the required furniture items as outlined in Title 22. Smoke and Carbon Monoxide detectors are in place and functioning. There is a common hallway bathroom in between resident room 2 and 3. This bathrooms water temperature is measured at 105.6F. There is an additional bathroom in room 1. Water temperature is measured at 105.5F in this bathroom. Both bathrooms had non-skid mats available for resident use, as well as required bathroom supplies such as soap, paper towels, toilet paper, and trash cans.