Senior Care Records.

Facility Evaluation Report

Sycamore Home, San Martin09/28/2023Licence 435202728

Capacity4
Census4
Date signed09/28/2023 04:03:59 PM
The inspector’s account

Licensing Program Analysts (LPAs) Simi Rai and Mita Pardoza conducted an unannounced Required 1 Year visit and met with Administrator, Noel Huante. LPAs observed 7 staff and 3 residents at the facility and 1 resident was attending day program.

During visit, LPAs toured the inside and outside of the facility. When touring the outside area of the facility, the exits were cleared of obstruction. LPAs toured the facility kitchen and observed food supply of at least 2 days of perishable food and at least 7 days of nonperishable food. Sharps and medications were locked in secured areas. LPAs observed additional food supply areas and secured areas for cleaning supplies and laundry detergents.

The facility bathroom had available soap, paper towels, and trash cans with lids. The shower had grab bars and non-skid mats. The water temperature in the bathroom sinks ranged from 117.4F-118.8F. The water temperature in the kitchen sinks ranged from 108.7F and 118.0F. Fire extinguisher was observed and inspected on August 3rd, 2023. Facility smoke detectors and carbon monoxide detectors were in working condition. 4 out of 4 resident bedrooms had available bedding, drawers, and functioning lights.

LPAs reviewed facility records for 4 staff and 2 residents. LPAs reviewed resident medications and central stored medication records.

No deficiencies were cited per California Code of Regulations, Title 22. This report was reviewed with Administrator, Noel Huante and a copy of the report was provided.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction