Facility Evaluation Report

Licensing Program Analyst (LPA) Esther Cortez conducted an unannounced required annual visit

to the facility. LPA met with the administrators Susana Vincecruz and Roberto Ramirez and explained the reason for the visit.

The LPA 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:

BEDROOMS: There are four resident bedrooms (two shared and two individual rooms). The resident rooms are set up with appropriate furnishings, clean linens, and sufficient lighting. At 12:32 p.m. the LPA observed 2 tubes of triad hydrophilic wound dressing, 1 tube of neosporin, one bottle of dermal wound cleaner, 2 bottles of Pepcid complete, one bottle of Dulcolax stool softner, 1 bottle of diabetic Tussin, and one box of Chloraseptic sore throat +cough in room #4, however per the resident's (R1's) LIC602 they cannot manage or store their own medications.

RESTROOMS: There are two bathrooms at the facility. The restroom has grab bars and a shower with non-skid materials. The hot water temperature measured within the required temperature.

COMMON SPACES: In the common areas, walls and flooring were checked for cleanliness and

good condition. At the time of the visit, common seating area and dining room furniture was

observed to be in good condition. The LPA observed the required postings. The fire extinguisher appeared fully charged and was last purchased on 09/15/2024. The facilities smoke detectors and carbon monoxide alarms were tested throughout the facility and functioned properly at the time of visit.