Facility Evaluation Report

License Program Analyst (LPA) Hansen arrived unannounced to conduct an Annual Required – 1 yr. visit of the facility. LPA was welcomed by Licensee/Administrator Doug Cattich. Facility is a single story 9 bedroom (1 staff & 1 double) RCFE that has a fire clearance for 9 Nonambulatory residents, of which 1 may be bedridden. There is currently a total of 7 residents, 5 with a dementia diagnosis and no currently under Hospice services.

LPA toured the facility on 7/22/2025 at 8:45 AM with Licensee/Administrator Doug Cattich; facility was found to be clean and at a comfortable temperature with all exits free from obstruction. Exits were equipped with auditory devices, and doors were activated at the time of the visit. Hot water temperature measured between 107.2 degrees F and 114.4 degrees F within Title 22 acceptable regulation of 105 to 120 degrees F in 5 of 5 resident’s bathrooms while touring facility on 7/22/2025 at 9:10 AM. The facility serves residents with dementia and has a plan of operation for special care and programming. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. Food stored in the kitchen refrigerator were properly stored as per regulations on this day at the time of the visit. Toxins are stored in a locked cabinet in the laundry room of the facility. Dangerous items are stored inaccessible to residents with dementia. There was a supply of cleaners, hygiene products and paper products available for residents. The bathrooms designated for residents at the facility were supplied with individual towels and hand soap dispensers. Bathrooms were equipped with necessary grab bars, although main bathroom where showers are given does not have slip-resistant mats, strips, or flooring in shower floor as required by Title 22 regulations. Facility was given TA during last years inspection for this issue on 7/25/2024 (see pics & LIC809-D). All bedrooms have lighting & appropriate furnishings. Receipt posted of pest control service, per Licensee monthly, last conducted 6/3/2025. Continued on LIC 809-C