Facility Evaluation Report

Licensing Program Analyst (LPA) Emily Peraldi conducted an unannounced required annual visit. At 2:13 p.m., the LPA spoke with staff and explained the reason for the visit. The Administrator was not available during the time of the visit and authorized staff, Sandra Zuniga to sign the report. This annual had a specific emphasis on infection control practices and procedures.

At 12:17 p.m., the LPA, along with staff toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that the facility is in compliance with Title 22 Regulations.

COMMON SPACES: All indoor and outdoor passages were free of obstruction. At the time of the visit, living room and recreational room furniture was observed to be in good condition. The LPA observed the fire extinguishers to be fully charged and last serviced on 02/16/2022. Signs are posted throughout facility to promote handwashing. At 2:59 p.m., fire/carbon monoxide detectors were tested and functioning properly. Medications and first aid kits are centrally stored and in a locked closet in the medication room. At 2:50 p.m., the LPA observed the back and front patio which has a covered outdoor area for client use. BEDROOMS: The LPA observed the client bedrooms, which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. RESTROOMS: Restrooms were observed to be clean and sanitary with hand soap, toilet paper and paper towels. At 2:46 p.m., the hot water in all the three (3) client restrooms measured between 124.3 and 126.4-degree Fahrenheit. At 2:55 p.m., the LPA spoke with the Administrator regarding the water temperature. The Administrator stated that the water temperature will be adjusted, and a water temperature log will be completed. The facility does not contain a full kitchen, only a kitchenette. The kitchenette consists of pantry and dry food storage area, refrigerator and freezer. As such, the facility does not contain 7-day supply of perishable and 2-day supply of non-perishable foods. Facility food for lunch and dinner is stored and prepared off-site. Breakfast is prepared in the kitchenette and snacks are available throughout the day for clients. Continued on LIC 809-C.