Facility Evaluation Report

License Program Analyst (LPA) Hansen arrived unannounced to conduct an annual required - 1 yr. visit of the facility. LPA was welcomed by staff Laura Lopez Monroy. Angelica Martinez - Licensee was contacted by staff and arrived during the visit. There were two caregivers providing care and supervision for 3 residents. Three residents were at day program. There is no residents currently with a diagnostic of dementia, as well no residents on Hospice or using oxygen.

LPA initiated a tour of the facility at 9:00 AM on 11/16/2023 and made the following observations: Facility was found to be clean and at a comfortable temperature with all passageways and exits free from obstructions. Resident rooms were furnished per regulation. Water temperature in resident's bathrooms measured at 118.5 degrees F and 119.1 degrees F within Title 22 acceptable regulation of 105 to 120 degrees F in 2 of 2 resident’s bathrooms while touring facility on 11/16/2023. Extra hygiene products and linens were available. Bathrooms had required bath mats and grab bars. Cabinet in garage containing cleaning supplies and toxins was unlocked along with cabinet underneath kitchen sink containing cleaning supplies, Regulation 87309(a)(see LIC809-D). Bathroom contained cloth towels and no paper towels for clients use, Regulation 87307(3)(c)(TV see LIC9102). Facility has at least two days of perishable and one week of non-perishable foods. Medications were centrally stored in kitchen cabinet although unlocked, Regulation 87465(h)(2) (see LIC809-D).

Fire extinguisher was last inspected 9/15/2023. Smoke detectors and Carbon Monoxide detectors located throughout facility were tested and operational. All six exit doors have auditory alerts that were functional at time of visit.