Facility Evaluation Report

Licensing Program Analyst (LPA) Shannan Hansen arrived unannounced to conduct a required Annual inspection and was greeted by Caregiver. Administrator Darwin Galicia arrived later. Facility has 4 residents with 1 with dementia diagnosis. Facility has fire clearance for 6 Non Ambulatory and cleared for a Hospice Waiver for 3, although no residents currently are on hospice.

At approximately 11 am LPA and staff toured the building and grounds. The facility was found to be clean and at a comfortable temperature. LPA observed at least a 2 day supply of perishable and 7 day supply of non-perishable food. Food was found to be stored in a safe manner with open items covered and labeled. LPA observed locked kitchen cabinet containing cleaning supplies and sharp knives.

All bedrooms were equipped with lighting/lamp, night stand, and chest of drawers. All bedrooms were clean and in good repair. Extra hygiene products and linens were available. Resident bathrooms had required slip resistant mats and grab bars. Water temperature in sink(s) accessible to residents in care measured at 107.6 to 107.7 degrees F, within the allowable range of 105 to 120 degrees F.

Fire extinguishers were observed to be charged 19/2025. Smoke/Carbon Monoxide detectors located throughout the facility were tested and operational. Exit doors have an auditory alert system that was functional at time of inspection. Facility’s last quarterly disaster drill was conducted on 01/03/2025.

At approximately 12 PM, LPA reviewed 4 of 4 resident records and found 4 of 4 residents had current Physician Assessmentss on file although 2 of 4 residents did not have current Pre-Admissions Appraisals on file, (see LIC 809-D)