Facility Evaluation Report

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

During visit, LPA Marrufo toured the facility inside and out. LPA toured the kitchen area and observed there to be locked storage areas for sharp objects and another locked storage area for cleaning supplies. LPA reviewed the first aid kit and found it to be complete. LPA toured the food supply in the kitchen and in the facility basement 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 toured four out of four resident bathrooms. Each bathroom had working lights and available soap and paper towels. The water temperatures in the bathroom sinks ranged from 111 F to 119 F.

LPA toured the facility hallways and resident rooms. LPA tested the facility smoke detector system and found it to function properly when tested. Each bedroom had working lights and available bedding and clothing storage areas. LPA toured the outside area and found the exits to be clear of obstructions.

LPA reviewed five resident records, including Centrally Stored Medication and Destruction Records, and found them to be complete. LPA reviewed five staff records and found them to be complete. The last recorded emergency disaster drill was conducted on 04/16/2025.

No deficiencies were cited at this time as per California Code of Regulations Title 22. This report was reviewed with Administrator Lusanta Kaiyom and a copy of this report was provided.