Facility Evaluation Report

Licensing Program Analyst (LPA) Maria (Mita) Partoza conducted an unannounced Required 1 Year visit and met with Lourdes Cera, House Manager (HM). HM stated the administrator (ADM) Christia Marie Mendoza-Vasquez was not present in the facility.

During visit, LPA toured the inside and outside of the facility, including kitchen, dining room, living room, 2 staff room, 3 resident bedrooms, 2 bathroom and laundry room. LPA observed that the kitchen was organized and sanitary. LPA observed that the kitchen stove was missing and observed a butane portable cook top. HM stated that the cook top is what they use temporarily while ADM purchases a new one to replace the broken stove. HM stated stove broke this morning (5/6/2024).

LPA observed two days of perishable and 7 days of non-perishable food supply. Sharps and medications were locked in secured areas. LPAs observed locked and secured areas for the cleaning supplies and laundry detergents. Fire extinguisher located in the kitchen was recently inspected on 3/19/2024.

The facility bathroom had available soap. LPA observed that paper towel was missing. The shower had grab bars and a shower chair. The water temperature was measured at 113.3 degree F.

Facility smoke and carbon monoxide detectors were tested and found to be functioning when tested. Three out of three resident bedrooms had available bedding, drawers, and functioning lights. LPA observed a hammock, a mattress on the covered back porch and blankets hanging on the clothes line. HM stated that resident R1's uses the hammock and prefers to sleep at the covered back porch rather than the bedroom. R1s bedroom have a bed with air mattress. HM showed. HM and Staff (S1) stated that R1 will sleep in the bedroom for a few minutes, but will get up and go to the covered back porch to sleep. HM and S1 stated R1 will sleep outside at night. HM stated that R1 has irregular sleeping patterns. R1 will not sleep for 2 to 3 nights in a week. page 1 of 2