Facility Evaluation Report

Licensing Program Analysts (LPAs) Kelly Dulek and Esther Cortez arrived at the facility unannounced to conduct a required annual visit at 12:16PM. LPAs were greeted by the Licensee, Esmeralda Ocampo-Nunez. Entrance interview conducted.

At 12:25PM, the LPAs, along with the Licensee toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that facility is in compliance with Title 22 Regulations. The following was observed:

BEDROOMS: The LPAs observed resident bedrooms, which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. The facility consists of 5 (five) total bedrooms, 3 (three) are designated for resident use and 2 (two) are designated for staff use. Staff bedrooms were observed locked. 1 (one) staff room has a restroom, but it is not currently permitted. The Licensee indicated she is working with a contractor who will be obtaining proper permits.

RESTROOMS : Observed beginning at 12:26PM, restrooms are relatively clean and sanitary and in operating condition with grab bars and non-skid surfaces. At 12:26PM, LPAs observed disinfecting wipes under the sink in the shared resident restroom, accessible to residents in care. At 12:30PM, hot water measured at 120.0 degrees Fahrenheit in the common resident restroom and at 12:35PM, hot water measured at 119.4 degrees Fahrenheit in the private resident restroom. At 12:35PM, LPAs observed Glade Air Freshener in the private resident restroom, accessible to residents in care.

COMMON AREAS : The LPAs observed common area to be relatively clean and properly furnished at the time of the visit. The LPAs observed the fire extinguishers to be fully charged and last serviced on 12/14/2021. During today's visit, the fire extinguishers were serviced and tags updated with the current date.