Facility Evaluation Report

Licensing Program Analyst (LPA) Alviso conducted a continuation of the Annual visit, on 6/8/23 at approximately 9:40am, and met with Administrator Maria Cortez. The Required Annual visit was started on 4/28/23, see report LIC809.

Hospice care waiver approved for thirteen(13) residents. Facility has an approved dementia plan of operation. Facility has submitted the required Infection Control Plan, which is part of the facility's plan of operation. The facility does have a required emergency disaster plan, including emergency(s) and evacuation plan. Fire clearance approval is for 80 non-ambulatory residents, which includes 4 bedridden.

LPA reviewed five(5) staff records. All staff have criminal record clearance as required by regulation. LPA reviewed staff training on file. Staff have required First Aid and CPR certification as required.

Facility was observed to be clean, orderly, and at a comfortable temperature during today's visit. LPA observed exits free from obstruction. Fire extinguishers, twenty-two(22), were serviced and tagged as required- expires 2/21/24. All common areas, hallways, and bathrooms seen by the LPA were observed to have sufficient lighting. All stairwells, two(2) of them, had an evacuation chair with instructions of how to use the chair posted up as required. Emergency bonder was observed to be up front at the concierge desk area. The storage lock box with master keys to rooms and facility vehicles to be used in facility emergencies was observed in the mail/fax room on the first floor. The facility has emergency supplies, including food and water to meet requirements of the 72 hour shelter in place. The kitchen was observed to have a sufficient supply of perishable and non-perishable food. Facility has a sufficient supply of cleaners, hygiene items, PPE supply, and paper products. LPA observed the theater room to be clean and orderly, with a movie playing. Elevator was inspected and cleared on 6/5/23. facility waiting on new permit to post up in the elevator.