Facility Evaluation Report

At approximately 8:25 AM, Licensing Program Analyst (LPA) Star Stevenson arrived unannounced to conduct a required 1-year annual inspection and was greeted by staff member Ryan Bernado. Administrator and licensee were notified of today's inspection and licensee Alma Corsiga arrived at 8:35 AM, while administrator Angel Dean arrived at approximately 9:00 AM to assist with today's inspection.

Facility is a Residential Care Facility for the Elderly (RCFE) with four (4) residents in care. Three (3) residents were away from the facility either at Day Program or on a community outing and one (1) resident was present during today's inspection. Facility has a hospice waiver for two (2), with no hospice residents currently in care, and is approved for all non-ambulatory residents.

At approximately 09:00 AM, LPA initiated a tour of the facility with administrator and observed the following: Facility is a two story home, was a comfortable temperature, and passageways were free from obstructions. All residents live on the first floor of facility and Licensee's family lives on the second floor. Water temperatures in Residents' bathrooms measured within the allowable range of 105 to 120 degrees F per Title 22 regulations. LPA observed a supply of clean linens, paper products, and incontinent care briefs available to residents. Residents' bedrooms were inspected and observed to have appropriate furnishings as outlined in Title 22 regulations.

The drawer faces of two (2) kitchen drawers that were empty were missing and LPA observed fence boards, poles and other debris that could present a tripping hazard present and a T echnical Advisory for facility maintainence and repair was issued. CCR 87303(a)