Facility Evaluation Report

Licensing Program Analyst (LPA) Alviso conducted a Required- 1 Year visit, on 12/10/24 at approximately 10:00am, and met with Licensee/Administrator Angelica Martinez.

Fire clearance is approved for six (6) non-ambulatory, of which one (1) may be bedridden. Facility has an approved dementia plan of operation. There is an approved hospice waiver for two (2) residents. Facility has an infection control plan as required. Facility has an emergency disaster plan as required.

LPA toured the facility with the Administrator. Hot water was checked at 116. degrees Fahrenheit, which is within regulation. The food supply was sufficient in perishable and non-perishable items. The facility had a sufficient supply of linens, furnishings, paper products, hygiene items, cleaners/disinfectants, and personal protective equipment (PPE) for use by the facility. The exits were free and clear from obstruction. All medications were locked and inaccessible to residents in care. All cleaners/disinfectants were locked and inaccessible to residents in care.

Facility has two (2) fire extinguishers that were serviced and tagged as required. The facility had all required smoke alarms, all working appropriately. Facility carbon monoxide detector was working appropriately. All exits had auditory alarms.

There are currently five (5) residents in care; Four (4) of the residents were at day program during the inspection. LPA reviewed five resident files, including medication records.

LPA reviewed four staff files, including training. All staff have criminal record clearance as required. All staff have first aid and cpr certification as required.