Facility Evaluation Report
On 04/20/2025, Licensing Program Analyst (LPA) Arielle Pascua arrived to this facility unannounced to conduct an Annual Visit. LPA Pascua was greeted by Facility Designated Administrator (FDA) Guillermina Zepeda and explained the purpose of the visit. Current census was 27. A brief interview was conducted with FDA Zepeda. This facility is licensed for 31 residents, of which 25 may be non-ambulatory.
LPA reviewed 5 resident files. 5 out of 5 resident files were current and up to date. LPA reviewed 6 staff files. 6 out of 6 staff files were current and up to date. The facility Administrator has an administrator certificate #6025364740 and is awaiting renewal from the department.
LPA Pascua observed a locked centralized stored medication cabinet located in the office. Along with the staff member, the LPA observed, reviewed, and compared resident medication and electronic medication dispensing logs. First Aid Kit was present and contained all of the required components.
A tour with FDA Zepeda was conducted. Fire extinguisher located throughout the facility. was serviced by U.S.A. Stanislaus Fire on 07/29/2024 and is in compliance at this time. Carbon monoxide, smoke detectors and call lights were observed to be in good repair.
Dining areas, living areas, and all other areas intended for resident use were toured. It was observed that furniture and furnishings were sufficient and able to meet the needs of the residents at this time.
Kitchen area was toured. LPA observed a sufficient amount of 2 day perishable and 7 day non-perishable food supply to meet the residents needs. Knives were observed to be locked and made inaccessible to the residents in care. Additional food supply was identified in an outside storage.
A tour of the laundry room was conducted, laundry detergent, bleach and all other cleaning supplies were made inaccessible to the residents at this time.
A tour of the resident bedrooms was conducted. Resident furniture was observed to be sufficient to meet the resident needs at this time.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction