Facility Evaluation Report

Licensing Program Analyst (LPA) Contreras arrived unannounced to conduct a required annual inspection and was greeted by administrator (admin) Mary Jane Mendoza. Facility is an Adult Residential Care Facility for the Elderly with an approved fire clearance for capacity of 6 (six) residents. There are currently four (4) residents in care.

LPA toured the building and grounds which was found to be clean and at a comfortable temperature. LPA observed all walkways and exits to be unobstructed. All required postings were in a highly visible area. Fire extinguishers were charged and last inspected 5/19/2025. Fire alarm and carbon monoxide alarms all tested and operational.Outdoor furniture accessible for resident use. Water temperature check measured within regulation at faucets accessible to residents within the allowable range of 105 to 120 degrees F. Resident bathrooms observed to have bath mat and grab bar. Disaster drills are being conducted quarterly.

All bedrooms were equipped with required furnishing .There is a signal system on each resident's bedroom door to alert staff for assistance. One out of four room signal system was not operational. Admin replaced batteries and LPA had conversation to ensure that it is kept on and functioning at all times (Technical Violation given). Facility had an ample supply of linens, towels and extra hygiene products for residents. LPA observed at least a 2 day supply of perishable and 7 day supply of non-perishable foods. Snacks accessible for residents. Emergency food was observed to meet the 72 hour emergency supply. Emergency water not observed to meet the 72 hour emergency supply (Technical Violation given). Facility kitchen, refrigerators and freezers were clean, and food stored properly. Expiration dates were noted in food items found in refrigerator. Toxins are locked and inaccessible to residents. Sharps and knives were locked. Phone accessible for resident use.