Facility Evaluation Report

Licensing Program Analyst (LPA) Alviso conducted a Required-1 Year visit, on 4/11/23 at approximately 9:35am, and met with Caregiver Claudia Maciel. LPA observed a total of two(2) caregivers on duty. Mary Garcia, Licensee/Administrator was contacted notifying her of the LPA's arrival to the facility. Garcia arrived within 30 minutes of being notified.

Facility has an approved dementia plan of operation. There is an approved hospice waiver for four(4) residents. Facility submitted to the Department the required infection control plan. Fire clearance is approved for six (6) non-ambulatory, which includes one(1) bedridden, any resident room may be used for the bedridden (1)clearance.

There are five(5) residents in care. LPA reviewed five(5) of five(5) resident files; All resident files were found to be complete.

All three(3) staff have criminal record clearance and are associated as required. LPA reviewed three(3) of three(3) staff files. Staff S1 is a Registered Nurse, license is maintained and active.

Facility was found to be clean, orderly, and at a comfortable temperature with all exits free from obstruction. All eleven(11) smoke alarms, which are hard wired, were working properly during the inspection. Three fire extinguishers were serviced and tagged as required. Medications were stored and locked making them inaccessible to residents. All toxins and cleaners were stored in locked cabinets, and inaccessible to residents in care. There was a sufficient supply of hygiene products, cleaning supplies, and paper products for use as needed. All exit alarms were on exit doors and working properly. All bathrooms had grab bars, and non-slip mat/flooring for bathing/showering as needed. Facility has a sufficient supply of personal protective equipment(PPE) for staff use as needed.