Facility Evaluation Report

Licensing Program Analyst (LPA) Trevor Byrne arrived at the facility unannounced to conduct a required annual visit at 09:57 AM. LPA met with facility staff who reached out to Licensee/Administrator Victor Hernandez who arrived on site at 9:59 AM. Entrance interview conducted.

Beginning at 10:00 AM, the LPA, along with Licensee/Administrator 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:

Fire extinguisher is fully charged and recently serviced on 05/28/2024. Carbon monoxide detector was tested at 1:23 PM and was functional at the time of the visit. Fire alarm is centrally located and can not be shut off without the fire department on site at the facility.

KITCHEN : Kitchen was observed to be clean. Kitchen appliances appeared to be in operable condition. The facility has a sufficient supply of 7 (seven) days non-perishable and 2 (two) days perishable food. Knives were observed to be locked in a drawer. Cleaning supplies are located in a locked under-sink cabinet. At 10:02 AM, LPA began checking the food supply in the kitchen pantry. All food items observed were of good quality and not expired.

GARAGE : The garage is kept locked and inaccessible to clients in care. A washer and dryer were observed and laundry chemicals were properly stored. The facility maintains an adequate supply of emergency food and water for all residents and staff members.

BEDROOMS : There are 5 (five) total bedrooms in the facility; 2 (two) are designated as private resident rooms, 2 (two) are designated as shared resident rooms, and 1 (one) is utilized as a staff room. All resident rooms were observed to be furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. Report Continued on LIC 809-C