Facility Evaluation Report

Licensing Program Analyst (LPA) Jill Nakagawa arrived unannounced to conduct a Required - 1 Year inspection and met with Administrator Josephine Mendoza. There are currently 6 residents in care. There were 2 staff at the time of inspection. This facility is licensed for 6 non-ambulatory residents, with hospice waiver approved for 2. There are currently no residents on hospice.

LPA toured facility and grounds and observed all required signs posted in common areas. Infection control practices are present. Visitors are asked to sign in and face coverings and hand sanitizer are available. Facility has a 30-day supply of PPE. Facility has also submitted their Infection Control plan, which is a part of their Plan of Operation.

Facility was found to be at a comfortable temperature of 71-72 F with all exits free from obstruction. Facility has at least two days supply of perishable and one week of non-perishable foods and items are stored properly. Fire Extinguishers were fully charged, and are due to be serviced next week. The grounds are clean and provide easy access for the residents to enjoy fresh air and many plants and fruit trees. The shed in the back yard is for storage of equipment only. The bedrooms are all furnished as required. Bathrooms were clean and sanitary and supplied with soap and paper towels, and non-skid mats and grab bars. The living room and sun room were equipped with comfortable chairs. The dining room was a hub of activity.