Facility Evaluation Report

Licensing Program Analyst (LPA) Contreras arrived unannounced to conduct a required annual inspection and was greeted by Administrator (admin) Estrella Valendo. Facility is an Adult Residential Facility for the Elderly licensed for a capacity of 6 residents. There is currently 1 resident in care.

LPA toured the building and grounds which was found to be at a comfortable temperature. LPA observed at least a 2- day supply of perishable and 7- day supply of non-perishable food. Expiration dates were not noted in some food items in refrigerato r (Technical Violation given). Knives found in kitchen not secure or locked accessible to resident (Deficiency cited, see 809D) Civil Penalty for Repeat Violation Assessed. Resident bathroom had required bath mat and grab bar. Bathroom found with paper towels and toilet paper. Dryer and washer found operational. Toxins found in laundry room was found unlocked (Deficiency Cited, see 809D ) Water temperature in sink accessible to residents in care measured within the allowable range of 105 to 120 degrees F. One resident bedroom is in use and observed to be equipped with lighting, night stand, and chest of drawer. LPA toured the outside backyard of facility and observed that outdoor studio apartment was removed and replaced with patio furniture. Noticeable spider webs and collected dust observed throughout facility (Technical Violation given). LPA observed garage had vermin droppings and noticeable odor of decay throughout the garage . In addition, vermin observed in kitchen floor (Deficiency cited, see 809D) Civil Penalty for Repeat Violation Assessed.

At approximately 12:00, LPA conducted file review for one resident. ID Emergency Information missing for resident. LPA printed copy and advised admin to sign and keep in file. LPA conducted file review for 2 staff. Training found to be up to date. LIC503 Health Screening missing for S1, TB cleare d ( Technical Violation given).