Facility Evaluation Report

12/11/2025, Licensing Program Analyst (LPA) Loera conducted an unannounced Annual Required – 1 yr. inspection visit for this facility. There are currently four residents in care. Facility approved/cleared for six non-ambulatory, one bedridden, and hospice waiver approved for two residents. LPA was greeted by staff.

Administrator, Matilde Verano arrived shortly after.

LPA and administrator toured the building and grounds. The facility was found to be at a comfortable temperature. LPA observed a 2 day supply of perishable and 7 day supply of non-perishable food. LPA and administrator observed a few canned food goods to be expired (Technical Violation).

Facility has required postings up. All rooms were furnished per regulation. All rooms were in good repair. Extra hygiene products and linens were available. Bathrooms had appropriate grab bars, non slip mats, and trash cans had tight fitting lids. Water temperature in sinks accessible to residents in care were measured and found to be within the range of 105 to 120 degrees F. Fire extinguishers were last inspected January 2025. Smoke/Carbon Monoxide detectors located throughout the facility were tested and operational. LPA observed auditory devices to be in working order. Sharps are located in a locked cabinet in the kitchen. Medications were found to be centrally stored in a locked cabinet in the kitchen. LPA conducted spot medication count and found all prescription medication to be properly recorded on the Centrally Stored Medication Record.

LPA conducted a review of 3 resident records. Hospice plans were reviewed and all records had the required documentation. One out of three residents did not have an updated medical assessment. Per conversation with administrator, they have had their yearly medical appointment and have been reaching out to Kaiser Medical Records with no response.