Facility Evaluation Report

Licensing Program Analyst (LPA) David Marrufo conducted an unannounced Required 1 Year visit and met with Maria Mendoza, Program Director.

During visit, LPA toured the facility inside and out. LPA toured the activity rooms and gym areas. LPA reviewed the facility first aid kit and found it to be complete. LPA tested two out of two carbon monoxide detectors and found them to function properly when tested. LPA observed the smoke detector system and observed that the last recorded inspection of the smoke detector system occurred on 11/2024. LPA toured the facility exits and found them to be clear of obstructions.

LPA reviewed two out of two resident Centrally Stored Medication and Destruction Records and found them to be complete. LPA reviewed 7 resident records and found them to be complete. LPA reviewed 7 staff records and found 1 out of 7 reviewed staff records was missing a health screening form.

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 were 110 F, 110 F, 105 F, and 88 F.

Deficiencies were cited as per California Code of Regulations Title 22. See LIC809-D pages for more information.

A civil penalty of $250 is being assessed today for a repeated violation. See LIC421FC for more information.

This report was reviewed with Program Director Maria Mendoza and a copy of this report and appeal rights were provided.