Facility Evaluation Report

At 09:00 a.m. Licensing Program Analyst (LPA) Esther Cortez arrived at the facility unannounced to conduct a required annual visit. The LPA was greeted by Administrator Assistant Johnna Udden and informed them of the reason for the visit. Administrator Helen Rose T. Busch arrived shortly.

At 09:15 a.m. the LPA conducted a tour of the physical plant with the Administrator to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. The following was noted: Facility is a single-story residence that consists of four (4) resident bedrooms, one (1) staff room, and three (3) restrooms. The LPA observed one (1) fire extinguishers which was fully charged and last serviced 10/16/2023. At 9:25 a.m. all smoke alarms and carbon monoxide detectors were tested and functioned properly. The LPA observed all required postings in the hallway near the entrance area. The facility serves residents with dementia, the auditory alarms on the exit doors were tested and functioned properly at the time of visit.

Kitchen : During the facility tour the kitchen appeared clean and the appliances and fixtures functional. LPA observed a sufficient amount of perishable and non-perishable food at the facility. Food is prepared based on the menu. Snacks and beverages are always available for the residents. At 9:17 a.m. the LPA observed a pair of scissors inside a drawer of the kitchen island, and a pair of kitchen scissors in the dish drying basket next to the sink. Upon observation, staff locked away both pairs of scissors.

Bedrooms: The resident bedrooms were properly furnished with at least one chair, nightstand and sufficient lighting for each resident. The bedrooms had appropriate and adequate bedding and linens such as sheets, pillowcases, mattress pads, and blankets.