Facility Evaluation Report

Licensing Program Analyst (LPA) Alviso, conduct a Required- 1 Year inspection and met with Lead caregiver Joy Montes. LPA observed another caregiver working, Paul Montes. Administrator Ryanne Tapnio was not available to meet with the LPA.

Facility has a required infection control plan. Facility has a required emergency disaster plan. Facility has an approved hospice waiver for two (2) residents. There is an approved plan of dementia care. Fire clearance is approved for six (6) non-ambulatory.

The LPA reviewed five (5) client files. The LPA reviewed six (6) staff files. All staff had criminal record clearance as required.

LPA toured the facility with caregiver Joy. Hot water was checked at 108.5 Fahrenheit. Fire extinguishers (two) were serviced and tagged as required-expires 10/30/23. The facility was clean and orderly. Carbon monoxide detector was working properly. Exit alarms were working properly. Food supply was sufficient. Sufficient supply of cleaners, paper products, and hygiene products. Sufficient supply of personal protective equipment (PPE). Bathrooms were clean and orderly: Bathrooms had grab bars and non-slip mats/flooring for resident use.

Licensee/Administrator to submit the following documents by 11/17/23:

LIC 308 Designation of Administrative Responsibility

LIC 610 E Emergency Disaster Plan for RCFE -reviewed & updated as needed

Infection Control Plan-reviewed & updated as needed

LIC400 Handling of Client Cash Resources, include copy of surety bond.

LPA observed vegetables in the refrigerator that were no longer fresh, and of good quality, some were old and rotting. LPA obtained pictures.