Facility Evaluation Report

Licensing Program Analyst (LPA) Sarah Benson made a Pre-licensing Inspection on today's date of 12/27/2023 and met with Administrator Cynthia Rubio. Administrator certificate is current. This is a Change of Ownership pre-licensing, there are currently five (5) residents living in the home.

LPA toured Physical Plant, Food Service, Common Areas, Bedrooms, Bathrooms, Kitchen, Medication Storage, and Courtyard. Fire extinguishers, smoke detectors, and fire sprinklers were observed. Kitchen was clean and in good repair, LPA observed proper storage area for food. Facility has non-perishable and perishable food supply. Resident bedrooms were checked and were observed to have the required furniture. LPA toured the courtyards to ensure safety. LPA observed locked areas where items such as but not limited to, knives, medication, and toxins are stored inaccessible to residents. Hot water temperature measured within required Title 22 regulations of 105 degrees F and 120 degrees F.

The LPA reviewed resident files, staff files and the facility's Emergency and Disaster Preparedness Binder. The facilities first aid kit is fully stocked and ready for use.

Requirements for pre-licensing inspection met.

Exit interview preformed and a copy of report given to facility representative.