Facility Evaluation Report

Licensing Program Analyst (LPA) Jill Nakagawa arrived unannounced to conduct an Annual Required 1 Year inspection and met with Administrator Johnny Copero. This facility is licensed for 6 Non-ambulatory residents with a Hospice Waiver approved for 1 of the residents and no Bedridden approval. There were 6 residents and 2 staff on site at the time of inspection.

LPA and Administrator toured the facility and made the following observations: Facility was a comfortable temperature and passageways were free from obstructions. Residents' rooms were furnished per regulation. Water temperature in bathrooms used by residents is within the required range of 105 to 120 degrees F allowed per regulation. Extra hygiene products and linens were available. Closet containing cleaning supplies was locked. Facility has at least two days of perishable and one week of non-perishable foods which appeared to be of quality and stored per regulation. Medications were centrally stored and locked. Facility maintains emergency food and water supplies.

Fire extinguishers were fully charged and last serviced May 1, 2024. Smoke and Carbon Monoxide detectors located throughout the facility were tested and operational. Most recent disaster drill was conducted 08/16/2024.

Staff have required First Aid and CPR certificates. Johnny "Juanito" Copero filed for renewal of Administrator's Certificate. Required postings were observed. Medication records were reviewed.