Facility Evaluation Report

At approximately 09:35AM, Licensing Program Analyst (LPA) Ali Deniz arrived unannounced at ST. JUDE RESIDENTIAL FACILITY LLC. for the purpose of conducting a Required 1-year inspection. LPA was greeted at the door by Caregiver, Malourdes Lapuz, and was granted access into the facility. Licensee, Rose Marie Devera arrived about 20 minutes later. There is a total of 4 residents at facility. Two residents were attending day program during this visit. Facility is a 1 story building with 4 resident bedrooms, 1 staff bedroom, 2 bathrooms, and common spaces.

At approximately 10:15AM, LPA toured the building and grounds which was found to be clean and in good repair. LPA observed all walkways and exits to be unobstructed. All notices that are required to be posted have been posted and are in a highly visible area. LPA observed activity supplies for resident use. The facility has a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. Facility has enough water for the residents to operate one week in an emergency water outage. Facility kitchen, refrigerators and freezers were clean, and food was stored properly. Toxins are stored in a locked kitchen cabinet in the kitchen. Water temperature measured within regulation between 105- and 120-degrees F at faucets accessible to residents. Fire extinguishers were inspected and charged on 10/30/2024. Smoke and Carbon Monoxide detectors were present and operational. There was enough lighting in all common areas, resident rooms, and hallways. Facility had emergency lightning supplies. Medication is centrally stored and secure.

At approximately 11:10PM, LPA reviewed 4 resident records and found 4 out of 4 residents records contained current physician's orders and Appraisal & Needs Service Plan on file. 1 out of 4 residents (R1) did not have signed admission agreements on file. Medication records are thorough and contained physician's orders for each resident.