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 Julia Espena at 11:30 AM. The home is vendored by Tri-Counties Regional Center as a level 3 home. The LPA, along with facility Administrator, 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:

Kitchen/Dining area : At 11:40 AM the LPA began touring the dining and kitchen area. Kitchen appliances appeared to be in operable condition. The facility has a sufficient supply of perishable and non-perishable food stored in the kitchen and in the garage. At 11:41 AM, the LPA observed the medication cart stored in the dining area to be unlocked. At 11:45 AM, the LPA observed the knife drawer unlocked and cabinet under the sink with 409 cleaner, Windex and other cleaning supplies to be unlocked. Both were locked during the inspection.

Common Areas: The living room was furnished appropriately. The carbon monoxide detector and smoke alarms were tested and found to be operational. The two fire extinguishers were fully charged and last serviced on 07/23/2021. Infection control signs are posted through out the facility. The backyard has a covered area for resident use. The washing machine and dryer are located outside. There is a locked cabinet for detergent and cleaning supplies. The facility has two common restrooms for resident use. Restrooms were observed to be clean and sanitary with hand soap and paper towels. At 11:54 AM the hot water temperature was tested in the first common restroom and it measured at 121.8 degrees F. The LPA also tested the water temperature with the licensee's thermometer and the water measured at 122 degrees F. The hot water heater was turned down during the inspection.

Bedrooms: The LPA observed the resident bedrooms, which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. Smoke alarms were operational. Report continued on LIC 809-C.