Facility Evaluation Report

Licensing Program Analyst (LPA) David Marrufo conducted an unannounced Required 1 Year visit and met with Bill and Debi Sanchez.

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 first aid kit and observed it to be complete.

LPA toured two out of two bathrooms and observed each bathroom to have available soap and paper towels. The water temperature in the bathroom sinks measured at 110 F to 116 F. LPA toured four out of four resident bedrooms. Each bedroom had working lights and available bedding and clothing storage areas. LPA tested the smoke/carbon monoxide detectors in the hallways and resident rooms and they all functioned properly when tested.

LPA toured the outside area of the facility. The outdoor exits were clear of obstructions.

LPA reviewed five out of five resident records, including the centrally stored medication and destruction records and the personal and incidental money logs, and found them to be complete. LPA reviewed five staff records and found them to be complete.

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