Facility Evaluation Report

At approximately 10:15am, Licensing Program Analyst (LPA) Contreras arrived unannounced to conduct a required annual inspection visit. LPA was greeted by facility administrator (admin) Josephine Kamau. Facility is a Residential Care Facility for the Elderly that has a fire clearance approved for 4 ambulatory of which 4 may be non-ambulatory. Facility has approved hospice waiver for 4 residents. Facility has 4 rooms and 2 restrooms accessible for residents.

LPA toured the building and grounds which was found to be clean and in good repair. Facility was clean and at a comfortable temperature. LPA observed all walkways and exits to be unobstructed. All required postings were in a highly visible area. Fire extinguishers were charged and last inspected 3/13/25. Fire alarms and carbon monoxide detector were tested and operational. All signal alarms throughout facility were operational and functional. Outdoor emergency exit clear from obstruction. Facility has outdoor sun room and backyard furniture accessible to residents. Facility's telephone was tested and was operational.

All bedrooms were equipped with lighting, a night stand and chest of drawers. All bedrooms were clean and in good repair. Resident bathroom had required bath mat and grab bar. Facility had an ample supply of linens and towels. LPA observed the 2 day supply of perishable food requirement and 7 days supply of non-perishable foods per Title 22 Regulations. Multiple food items found to be expired in pantry including granola bar box, cake mix and frosting box and canned goods (Deficiency cited, see 809D). Toxins are stored in a locked in garage. Sharps and knives were locked in lock box. Facility had emergency food and water for 72 hours. Water temperature measured at 114.3 and 113 degrees F at faucets accessible to residents which is within the allowable range of 105 to 120 degrees F. Disaster drills are conducted quarterly.