Facility Evaluation Report

Licensing Program Analyst (LPA) David Marrufo conducted an unannounced Required 1 Year visit and met with Administrator (ADM) Thelma Tan.

During visit, LPA Marrufo toured the facility inside and out. LPA toured the kitchen area and observed there to be a perishable food supply of at least two days and a non-perishable food supply of at least seven days. LPA observed the facility first aid kit and found it to be complete.

LPA tested the smoke detector system and the carbon monoxide detector and found them to function properly when tested.

LPA toured the outside area of the facility and found the exits to be clear of obstructions.

LPA toured three out of three resident bathrooms. Each bathroom had working lights and available soap and paper towels. The water temperatures in the bathroom sinks ranged from 105 F to 109 F.

LPA toured five out of five resident bedrooms. Each bedroom had available bedding and clothing storage areas as well as working lights.

LPA reviewed three out of three resident records, including Centrally Stored Medication and Destruction Records, and 3 staff records and found them to be complete. This report was reviewed with ADM Thelma Tan and a copy of this report was provided.