Facility Evaluation Report

At approximately 11:00 AM Licensing Program Analyst (LPA) Stevenson arrived unannounced to CONTINUE a required 1-year annual inspection and was greeted by co-licensee Eugene Poquiz. Licensee Alicia Poquiz arrived at approximately 11:45 AM to assist with today's continued inspection.

At approximately 11:10 AM the garage refrigerator was observed to be clean and organized and yard had been picked up to further reduce tripping hazards with elderly residents present.

At approximately 11:15 AM five (5) staff files were reviewed and five (5) of (5) files had required documents including health screening, TB testing, criminal clearance and 1st Aid/CPR training.

At approximately 12:10 PM, six (6) of six (6) resident files were observed to have all required documentation per title 22 regulation.

At 1:25 PM LPA observed medicines to be centrally stored and locked and medicine records to be accurate.

During today's inspection hospice nursing arrived to initiate hospice services for resident (R2) and licensee was advised to submit to licensing notification of initiation of hospice services and a list of required elements to submit was provided to licensee.

Technical violation and/or advisories cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

This report was reviewed with Licensee, Alicia Poquiz and Appeal rights were given.