Facility Evaluation Report
On 11/3/23 at 9:26 AM, Licensing Program Analyst (LPA) Malia Thao arrived unannounced to conduct an Annual inspection. LPA explained reason for inspection and was granted entry by staff. Licensee/Administrator (LIC) Eesaeng Martinez arrived a short time later. No residents were present during the inspection.
LPA toured the facility and did not observe any obstructions. Smoke and carbon monoxide combo detector tested and operational. All bedrooms observed with sufficient furnishings and lighting. Food supply was checked. Cleaning supplies checked and observed locked in closet. Sharps observed inaccessible in medication cabinet. Medications observed locked and inaccessible. Sample of resident and staff files reviewed. Administrator certificate pending recertification, certification #: 6051208735.
No deficiencies cited during this inspection.
An exit interview was conducted. A copy of this report was left with Licensee, whose signature on this form confirms receipt of these documents.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction