Facility Evaluation Report

Licensing Program Analyst (LPA) KaSandra Lopez conducted an unannounced Required 1 Year inspection at the facility today. The LPA met with Administrator Lourdes Ricafort and explained the reason for today's inspection. Today's Annual has a specific emphasis on infection control practices and procedures.

The LPA toured the physical plant areas inside and outside to ensure there are no health and safety hazards

and the facility is in compliance with Title 22 Regulations. The carbon monoxide detector and smoke alarms

were tested and all functioned properly. The fire extinguisher was last serviced on 06/07/2022.

KITCHEN: Kitchen appliances were in operable condition. The facility has a sufficient supply of perishable and non-perishable food. The LPA observed the pantry and refrigerator to be cluttered and in need of cleaning. The pantry had ants and spiders and numerous items with past best by dates food items including pineapple juice with a best by date of 7/15/21 and an unopened cereal box with a best by date of 11/27/21. The LPA also observed ants on the kitchen counters and general clutter on the counters. The refrigerator had numerous items and sauces in unmarked containers with no dates, lunch meat with an expiration date of 4/14/18, and mayonnaise with a best by date of 11/17/21. The Administrator stated these items belonged to her and staff and was not served to the residents.

BEDROOMS: The LPA observed four resident bedrooms and one staff bedroom. Resident bedrooms

which were furnished appropriately with clean linens and sufficient lighting. Alarms on exit doors are functioning.

RESTROOMS: There is one common hallway restroom and one on suite restroom for resident use. They were both clean and sanitary and in operating condition with hand soap, paper towels, and toilet paper. The hot water measured at 109.4 degrees F in the hallway restroom.