Facility Evaluation Report

Licensing Program Analyst (LPA) Valeria Conway arrived at the facility unannounced to conduct a required annual visit at 8:55 a.m. LPA initially met with staff Julius Pamplona. Administrator Ophelia McFadden was contacted and arrived shortly at 9:06 a.m. Entrance interview conducted.

The LPA, along with Administrator and the assistant administrator, Nikky Puga 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.

BEDROOMS: The facility consists of a total of five (5) bedrooms; four (4) designated for residents and one (1) designated for staff. Bedrooms #1 and #3 are designated for single use and bedrooms #2 and #4 are designated for double occupancy. The LPA observed the resident bedrooms, which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. During today visit, LPA observed staff room (room #5) be converted into a single use resident room. However, #5 does not have the appropriate fire clearance to retain any residents. LPA discussed that the facility needs to submit a new sketch along with the LIC200 and obtain appropriate fire clearance or move the resident back to a room with the appropriate clearance.