Facility Evaluation Report

At approximately 10:00 AM, Licensing Program Analyst (LPA) Star Stevenson arrived unannounced to conduct a required 1-year annual inspection and was greeted by caregivers who called Administrator Kristine Lorenzo and Administer-to-be Van Eduard-Alverez who arrived at approximately 10:25 AM. Facility is a Residential Care Facility for the Elderly (RCFE) with six (6) residents in care, two of whom were away at Day Programs during today's visit. Facility has a Hospice waiver for three (3) and a Dementia Care Plan and currently has one resident identified with dementia and none are receiving hospice care. Faculty is vendorized with North Bay Regional Center (NBRC)

At approximately 10:25 AM, LPA initiated a tour of the facility with Caregiver/Administrator and observed the following: Facility is a one story home, was a comfortable temperature, and passageways were free from obstructions. 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 and paper and incontinent care products available to residents. Residents' bedrooms were inspected and observed to have appropriate furnishings as outlined in Title 22 regulations. Cabinets containing cleaning supplies and other items that could pose a risk were locked. Facility has at least two days of perishable food and one week of non-perishable foods, as well as an emergency water supply and large emergency generator. LPA noted go-bags and buckets of non-perishable foods for each resident. LPA noted large televisions, and large reclining chairs and couches for resident/staff use.

There is a covered seating area in the backyard with outdoor space for activities. LPA observed a locked shed in the backyard which LPA inspected and observed the contents to consist of tools, chemicals, decorations, extra incontinent care products, PPE, a couch and two desks set-up for use as an office space. LPA observed an activity schedule and games, crafting supplies, and other activities available for resident use. Facility has an internet access device (an iPad) and internet service available to residents in care.