Facility Evaluation Report

Licensing Program Analysts (LPAs) Alviso and Contreras conducted a Required- 1 Year visit, on 4/1/25 at approximately 2:09pm, and met with Licensee/Administrator Mera Shaughnessey. There currently are six (6) residents in care. LPAs observed two caregivers on duty.

Facility has an approved dementia plan of operation. There is an approved hospice waiver for three(3)residents. Facility has a required infection control plan. Facility has an emergency and disaster plan as required. Facility does have a generator for emergencies if needed. The facility does have emergency food, water, and supplies to meet the "72 hour shelter in place" requirements.

LPA's toured the facility with administrator Mera Shaughnessey.All postings were visible to all entering facility. Hot water was measured at 116.9 and 120.5 degrees Fahrenheit. Fire extinguishers were dated December 2024. All exits were clear and free from obstruction. All bathrooms had grab bars, and shower mats for resident use. Backyard was free and clear of any hazards. Fire exit was clear and free of obstruction. Exit doors had auditory alarms. Food supply was sufficient. Facility had sufficient supply of cleaners, paper products, and personal protective equipment (PPE).

LPA are requesting the following documents be updated and submitted to CCL by 5/1//2025:

LIC308 - Designation of Administrator Responsibility