Facility Evaluation Report

Licensing Program Analyst (LPA) Christi Coppo arrived unannounced to conduct a required Annual inspection and was greeted by caregiver. Administrators Maggie and Heherson Garcia arrived later. Maggie Garcia Administrator Certificate 7008481740 expires 5/5/2025.

At approximately 9:30am LPA and Admin toured the building and grounds. Facility currently has six [6] residents in care, none of which are on hospice. LPA observed a noticeable order of incontinence upon entering facility ( deficiency cited, see 809D ). LPA observed items in bathroom such as storage rack and paper towel holder in bathroom to be dirty and dusty. The facility was found to be at a comfortable temperature. LPA observed camera to be present in the kitchen and in the common area living room. LPA asked to see notification and consent form signed by the residents' or residents' responsible parties for the cameras. Admin provided LPA a form with signatures, but none of the signatures matched the signatures of the residents or residents' responsible parties and the dates of the signatures is before many of the residents moved into the facility. LPA advised Admin to disclose and obtain the consent of residents and/or residents' responsible parties when utilizing video surveillance within the facility.

LPA observed at least a 2 day supply of perishable and 7 day supply of non-perishable food. Facility had fresh fruit but no fresh vegetables. Admin claims that today she was going to replenish the facility's supply of fresh vegetables, so Admin immediately went to store and purchased some fresh lettuce and vegetables. LPA observed opened bag of sugar and coffee in pantry without any seal or label. LPA advised to keep open items properly sealed after opening. Kitchen cabinet containing cleaning supplies was locked. Kitchen drawer with sharp knives locked. LPA observed a pair of scissors in unlocked kitchen drawer. LPA advised to keep objects that could present as a hazard to residents in locked drawer.