Facility Evaluation Report

Licensing Program Analyst (LPA) David Marrufo conducted an unannounced Required 1 Year Visit and met with Karen Grijalva, Program Manager.

During visit, LPA Marrufo toured the kitchen area. LPA observed 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 a secured drawer for sharp objects.

LPA toured the rear living unit that contained three bedrooms and a bathroom. LPA observed each bedroom had working lights and available bedding and clothing storage areas. LPA tested the smoke detectors in each bedroom and the carbon monoxide detector and found them to function properly when tested. LPA toured the bathroom and observed there to be available soap and paper towels. The light in the bathroom was functioning and the water temperature in the sink measured to be 114 F.

LPA toured three out of three bedrooms in the main building. Each bedroom had functioning lights and available bedding and clothing storage areas. The smoke detector in each bedroom and the carbon monoxide detector in the main building functioned properly when tested. LPA toured the bathroom in the main building and observed there to be working lights and available soap and paper towels. The water temperature in the bathroom sink measured at 114 F.

LPA toured the outside area and observed the outdoor exit to be clear of obstructions. LPA Marrufo reviewed Centrally Stored Medication and Destruction Records and Resident Records for five residents 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 Karen Grijalva and a copy of this report was provided.