Facility Evaluation Report

Licensing Program Analyst (LPA) Jill Nakagawa arrived unannounced to conduct a Required 1-Year Annual Inspection. There were 6 residents and 2 staff on site at the time of inspection. Administrator was out of town at the time of inspection, however staff were able to reach by phone. Licensee Melissa Gomez arrived shortly..

When LPA arrived at the facility they were greeted by 2 carestaff. There were 6 residents in care. LPA toured the facility with staff and found the facility to be clean and comfortable. Signs were posted appropriately informing the use of oxygen. Bathrooms were equipped with grab bars and non-skid rugs. Paper towels and antibacterial soap were also available in bathrooms used by residents and staff. All residents' rooms were furnished per regulation. Medications are securely stored in a locked medication cart and each resident has a 30-day supply of medications. Cleaning products were not accessible to residents in care.

Kitchen was clean and orderly and there were perishable and non-perishable food stores as required per Title 22. Sharps were locked and inaccessible to residents. The living room had reclining chairs for the comfort of each resident while watching television, listening to music or partaking in activities together. The backyard includes a lovely covered patio for residents to enjoy the warm weather under shelter from the sun, with lots of accessible gardening activities.

Staff and resident records were complete and within regulation. Fire clearance is for three (3) non-ambulatory and three (3) bedbound. There were 3 fire extinguishers, last charged and inspected on 6/20/2024; fully charged. There were two (2) carbon monoxide detectors, which were tested and operational. There were seven (7) smoke detectors, which are tested monthly. Last fire drill was conducted 3/30/25.

LPA requested: new Facility Sketch to include new structures and driveways on property, updated LIC 500 and proof of liability insurance.

There were no deficiencies found at the time of inspection. No citations cited during today's visit.