Facility Evaluation Report

On 10/17/23, Licensing Program Analyst (LPA) M. Medina conducted an unannounced Annual Required Inspection on this date. LPA introduced self and stated purpose of visit. LPA conducted facility tour with Licensee Marycruz Leyva. Marycruz Leyva also serves as facility Administrator Certificate #6050346735, expires 12/06/2024.

All residents were present during today's inspection.

Facility toured inside and outside. Facility observed to be clean, odor free, and at a comfortable temperature. All residents have private bedrooms, all bedrooms observed to have required furnishings. Linen observed to be clean and in good repair. Resident bathroom toured, bathroom fixtures observed to be in good repair and working. Hot water measured 106 degrees F. All common areas have adequate seating and lighting available for all residents. Medications observed to be stored and secured in medication room.

The fire extinguisher was serviced on 01/16/2023. Facility is equipped with a pull station and fire sprinkler system. The last fire drill was conducted on 9/29/2023 according to facility records.

LPA received updated LIC 9020, LIC 500, LIC610 during facility visit. Resident files reviewed during inspection.