Facility Evaluation Report

On 04/26/2024, Licensing Program Analyst (LPA) Arielle Pascua arrived unannounced to conduct an annual visit. LPA met with Facility Designated Administrator (FDA), Guillermina Zepeda and explained the purpose of the visit.

Current census was 26. A brief interview with FDA Zepeda was conducted.

This facility is licensed for 31 residents, of which 25 may be non-ambulatory.

A tour with FDA Zepeda was conducted. Fire extinguisher located throughout the facility. was serviced by U.S.A. Stanislaus Fire on 06/29/2023 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 there only one couch available able to sit 2-3 residents at a time and 4 plastic chairs around the common area.

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. It was observed that the resident bathrooms had cracked tiles near the drainage area, and had baseboards around the shower area to have been lifting. It was advised at this time the facility does not use this bathroom until this has been repaired.

A tour of the bathrooms was conducted. Hot water temperature was measured and observed to be within the required range of 105-120 degrees.

A tour of the second building was conducted. Dining areas, living areas, and all other areas intended for resident use were toured in this building. It was observed that furniture and furnishings were sufficient and able to meet the needs of the residents at this time.