Facility Evaluation Report

Licensing Program Analyst (LPA) David Marrufo conducted an unannounced Required 1 Year Visit and met with Grace Locsin, Administrator.

During visit, LPA 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 there to be locked cabinets and drawers for sharp objects and cleaning supplies. LPA observed the first aid kit and found it to be complete.

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 117 F to 119 F.

LPA toured six out of six resident bedrooms. Each bedroom had working lights and available bedding and clothing storage areas. LPA tested the smoke detectors in each bedroom and in the hallways and observed them all to function properly when tested. LPA tested the facility carbon monoxide detector and it functioned properly when tested. LPA toured the outside area and found the exits to be clear of obstructions.

LPA reviewed the resident records for six out of six residents, including the Centrally Stored Medication and Destruction Records, and found them to be complete. LPA reviewed five staff records and found them to be complete. No deficiencies were cited at this time as per California Code of Regulations Title 22. This report was reviewed with Administrator Grace Locsin and a copy of this report was provided.