Senior Care Records.

Facility Evaluation Report

Le Elen Manor III, Santa Rosa06/18/2024Licence 490112012

Capacity12
Census7
Date signed06/18/2024 01:48:49 PM
The inspector’s account

Licensing Program Analyst (LPA), Cuadra, arrived unannounced to conduct an Annual Required Inspection and met with Licensee, Tony Guevarra. Fees are current. Contact information reviewed.

LPA/Licensee initiated a tour of the facility at 11:30am and made the following observations: Facility was a comfortable temperature and passageways were free from obstructions. Client rooms were furnished per regulation. Water temperature in client's bathroom measured at 106, 108.7 and 117.1 degrees F which are within allowable range of 105 to 120 degrees F. Extra hygiene products and linens were available. Cabinets containing cleaning supplies and other items that could pose a risk were locked. Facility has at least two days of perishable and one week of non-perishable foods. Medications were centrally stored and locked. Cash resources and records were reviewed. Fire extinguisher was last inspected October, 2023. Smoke detectors and carbon monoxide located throughout the facility were tested and operational. Fire/Disaster drill was conducted April 21, 2024.

File review was initiated at 12:00 pm. Two staff files and five client files were reviewed. Staff have required First Aid and CPR certificates. Administrator Certificate for administrator Anthony Guevarra 6008632735 expires on 5/19/2025. Medications and medication records were reviewed. Required postings observed.

Licensee submitted updates of the following documents: Designation of Administrative Responsibility (LIC308), control of property and Personnel Report (LIC500).

No deficiencies cited during today's visit. Exit interview conducted with licensee and a copy of this report was given.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction