Facility Evaluation Report

At approximately 9:30 AM, Licensing Program Analyst (LPA) Elias Magdaleno arrived unannounced to conduct a required 1-year annual inspection and was greeted by caregiver. Administrator Dinah Belandres was called and arrived at approximately 10:10 AM. Licensee Rose Devera arrived shortly after. Facility is a Residential Care Facility for the Elderly (RCFE) with five (5) residents in care. Facility has Hospice waiver for three (3), with zero (0) Hospice residents currently in care and is approved for all non-ambulatory residents.

At approximately 10:15 AM, LPA initiated a tour of the facility with Administrator and observed the following: Facility is a one (1) story home, was a comfortable temperature, and passageways were free from obstructions. Fire extinguishers were last inspected 6/25. Smoke and Carbon Monoxide detectors were tested and operational during inspection. Water temperature measured 107.2 and 118.5 degrees F, which is within the allowable range of 105 to 120 degrees F per Title 22 regulations. LPA observed a supply of clean linens, hygiene, incontinent care, and paper products available for residents. Residents' bedrooms were inspected and observed to have all the appropriate furnishings as outlined in Title 22 regulations. Cabinets containing cleaning supplies and other items that could pose a risk were locked.

LPA observed at least a two (2) day supply of perishable and seven (7) day supply of non-perishable food, as well as an emergency water supply. Food was found to be stored in a safe manner with open items covered. There is a shaded seating area in the backyard with outdoor space for activities. LPA observed three (3) locked sheds in the backyard which were shown to contain staff belongings and additional equipment.