Facility Evaluation Report

At approximately 11:30 AM, Licensing Program Analyst (LPA) Stefanie Mutialu made an unannounced annual required inspection of this licensed senior care facility. LPA was greeted by Delia Ulbata, Licensee/Administrator. The facility is a single story home licensed for ten (10) non-ambulatory residents and a hospice waiver capacity of two (2). The facility currently provides care for 8 residents and there is one resident under hospice care at this time.

At approximately 11:45 AM, LPA and Administrator toured the building and grounds which was found to be clean and in good repair. LPA observed all walkways and exits to be unobstructed. All notices that are required to be posted have been posted and are in a highly visible area. Resident’s bedrooms, common areas, kitchen & food storage areas were inspected ,There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. Toxins are stored in a locked cabinet in the facility laundry room and kitchen. Sharps and other kitchen supplies that could pose danger if available to residents were found secured in the kitchen cabinet. There was a supply of cleaners, hygiene products and paper products available for residents. All resident’s bedrooms have lighting & appropriate furnishings. Water temperature measured within regulation between 109 and 113 degrees F at three of three faucets accessible to residents. One out of one fire extinguisher was inspected and charged. Thirteen out of thirteen Smoke Detectors and two out of two Carbon monoxide detector were present inspected. There was enough lighting in all common areas, resident rooms, and hallways.

Medications located in designated cabinet were found to be secured. LPA conducted a spot check of medications and found all administering and records to be in order.