Facility Evaluation Report

Licensing Program Analyst (LPA) Arlene Garcia conducted an unannounced annual / Infection Control visit on this date. LPA was greeted by Raquel Bargas, Caregiver (R!) and met with Quincy Beltran, Administrator . (AD)

LPA and AD, inspected physical plant including but not limited to the main kitchen, residents bedrooms and bathrooms, and dining/ living room areas. LPA observed the backyard that was free of debris .Hot water temperature measured 117 degrees in residents bathroom with the AD which is in required range of 105 to 120 degrees.

LPA observed sufficient 7 days non-perishable and 2 days perishable food supplies..

Last Fire Drill conduced dated 11/15//21. Fire extinguisher maintained 1/14/2021.

Fire alarm and carbon monoxide functional. LPA observed sharps and toxins locked.

LPA and AD observed centrally stored medications.

LPA reviewed 4 staff and 5 resident files. LPA observed all staff files complete.

Administrator Certificate valid 4/18/22. Liability Insurance current and meet criteria.

All persons in facility fully vaccinated.

LPA observed resident practicing social distancing. LPA observed 30 days PPE supply.

LPA observed residents had activities and all residents were engaged in their own activities. LPA observed 3 caregivers in the facility. All caregivers were attentive to all residents. LPA observed a resident requesting to outside. LPA observed the caregiver ensuring the resident was properly dressed and protected from cold weather and took the resident outside.