Facility Evaluation Report

Licensing Program Analyst (LPA) David Marrufo conducted an unannounced Required 1 Year visit and met with Tyrone Vega.

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 the first aid kit and found it to be complete.

LPA toured 9 out of 9 resident bedrooms. Each bedroom had working lights and available bedding and clothing storage areas. LPA tested the smoke and carbon monoxide detectors in the resident bedrooms, hallways, and dinning area and found them to function properly when tested.

LPA toured two out of two resident bathrooms. Each bathroom had available soap and paper towels. The water temperatures in the bathrooms measured from 108 F to 114 F.

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

LPA reviewed five out of five resident records and found them to be complete. LPA reviewed 5 staff records and found them to be complete.

See LIC809-C page for more information. Page 1 of 2.