Facility Evaluation Report

Licensing Program Analyst (LPA) Kelly Dulek arrived at the facility at 10:10AM for an unannounced annual inspection. Upon arrival, LPA met with Interim Executive Director (ED) Justine Ortiz. Entrance interview conducted.

Beginning at 10:35AM, the LPA along with Interim ED, toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. The following was observed:

5-Year fire sprinkler inspection was completed on 09/15/2023. No safety concerns were noted at that time. Fire extinguishers throughout the building were observed to be fully charged and last serviced on 09/15/2023.

MEMORY CARE: Memory Care is located on the first floor and has 18 (eighteen) rooms. Resident bedrooms are single and double occupancy with private bathrooms. A random sampling of 3 (three) resident rooms were observed to be furnished appropriately. Bathrooms were observed to be safe and sanitary with grab bars and non-skid mats. Hot water was measured in a sample of observed resident rooms and tested within the required range of 105 to 120 degrees Fahrenheit. Medications for the memory care unit are centrally stored and locked in the medication room. The indoor and outdoor areas of the memory unit are secured with a delayed egress system, which functioned properly during the visit. There are two outdoor gated courtyards designated for Memory Care. LPA observed sufficient outdoor furnishings and shaded outdoor space.

KITCHEN: The main kitchen and dining room are located on the 1st floor. Food is prepared in the main kitchen and delivered to the dining area and the Memory Care dining room. Facility dining room and commercial kitchen were inspected and found to be in compliance with Title 22 regulations. LPA observed