Facility Evaluation Report

Licensing Program Analyst (LPA) Fernandes-Goes conducted an unannounced Annual Required – 1 yr. Infection Control inspection to this facility and met with Melody Lee-Almond Executive Director & Mae Mora – Resident Services Director. Facility has 65 residents with 13 residents under Hospice care at this time. Facility offers activities during the day.

During facility tour on 10/15/2021 with staff Donaldo Antiado - Maintenance Director and Mae Mora – Resident Services Director, facility was found to be at a comfortable temperature. Sample of resident’s bedrooms, common areas, kitchen & food storage areas were inspected. Sample test of Smoke Detector & Carbon monoxide detector were found to be operational during the visit. Fire Extinguisher was found to be last charged on 04/2021 at the time of the visit. Annual fire/sprinkle inspection occurred on 10/13/2021. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. Food stored in the kitchen refrigerator was properly stored as per regulations on this day at the time of the visit. LPA observed that provisions are made for individuals with special dietary needs; facility keeps a variety of items on the menu, and facility has a board in the kitchen with a list of dietary needs for residents in care in addition to a dietary binder in the houses. Food is available for residents any time of the day. There is a daily activity schedule for residents. Toxins are stored in a locked housekeeping room. There was a supply of cleaners, hygiene products and paper products available for residents. All resident’s bedrooms have lighting & appropriate furnishings. Facility understands that hot water temperatures must measure within Title 22 acceptable regulations of 105 to 120 degrees F.

Facility has submitted a mitigation program plan that has been approved. Facility has posters that placed at facility. At this time facility is planning to have at entrance a table with hand sanitizer and other items designated for visitors and staff before coming into work. Facility have enough PPE supplies stored in the facility storage. Facility has admitted new residents since COVID-19. Continued LIC809-C