Facility Evaluation Report

Licensing Program Analysts (LPA) B. Miranda conducted an unannounced visit today for the facility’s annual inspection. LPA introduced themselves and was allowed entrance into the facility. LPA met with House Manager Rebecca Gurrola.

Facility is licensed for 4 residents and has a current census of 4. Water temperature was checked in the kitchen which read at 124.7 degrees Fahrenheit and the common bathroom which read at 125.2 degrees Fahrenheit. Fire Extinguisher was serviced 04/23/202 and is within the safety regulation period. Smoke detectors were tested and in working order. Facility did not have a carbon monoxide detector.

Diana Rico's Administrator's Certification expires 08/15/2027. Staff files were reviewed. Staff training does not have durations of training, instructor's name, or instructor's title. Resident files were reviewed, R1 and R2 do not have a physician's report on file. LPA observed medication logs for R2 & R3 which did not have the correct start date, RX#, quantity, fill date, or expiration date. Facility provided a log for disaster drills that are conducted monthly. First aid kit on site and complete. Toxins and cleaning supplies are locked and inaccessible. There is a locked storage for medications.

LPA inspected the interior and the exterior of the facility including the common living spaces, resident bedrooms, bathrooms, medication storage, kitchen, garage and outdoor areas. Bedrooms were clean, properly furnished, with adequate lighting, and in good repair. Food supply is adequate for 2-day perishable and 7-day nonperishable.