Facility Evaluation Report

On 02/20/2025, at approximately 2:55PM, Licensing Program Analyst (LPA) Star Stevenson and Licensing Program Manager (LPM) Kimberly Mota, arrived at the facility unannounced to conduct a 1-Year Required Annual Inspection. LPA and LPM met with Annie-Majorie Vinluan-caregiver and explained the purpose of the visit.

Facility has an approved Hospice Care Waiver for three (3). Clearance is approved for six (6) non-ambulatory of which one (1) can be bedridden in bedroom #1.

At approximately 3:00PM , LPA Stevenson and LPM Mota and caregiver toured facility together to ensure health and safety of residents in care. Areas toured include but are not limited to: common areas, resident bedrooms, backyard, shed, and common restrooms. LPA and LPM observed the facility to be clean, in good repair and odor-free. Water faucets accessible to clients were measured and found to have temperatures of 130.6F in Kitchen and 131.1F and 127.4F in back bathrooms (pictures taken)

LPA and LPM observed each bathroom to have the necessary grab bars, non-skid flooring or shower chair, paper towels, trash can with tight fitting lid. LPA and LPM observed each bedroom to have all the required furnishings, with working lights and windows with screens. One back bathroom was noted to have mold on the shower ceiling (photos taken)

Smoke detectors and carbon monoxide sensors were tested and observed to be in working order. Fire extinguisher were observed to last be inspected 12/2024 and charged. Last emergency drills were performed 10/2024

Last fire department inspection was on 01/21/2025. Facility has extra PPE and generator.

At approximately 3:30 PM the personnel roster (LIC500) was observed and all employees were deemed eligible to work at the site.

Facility has a 2-day perishable and a 7-day non-perishable amount of food. Facility medications are locked and inaccessible to residents in care. Repacked meets were not labeled, and bottom of freezer was dirty (photos taken)All toxins are locked and inaccessible to residents in care. LPA observed the first aid kit complete and ready for use.