Facility Evaluation Report

Licensing Program Analyst (LPA) Martha Arroyo arrived at the facility unannounced to conduct a required annual visit today. Upon arrival, there were two (2) staff and five (5) residents present. The staff contacted the Administrator via telephone and explained the reason for the visit. The Administrator, Susan Lumbres arrived at 10:35am. Entrance interview conducted.

Starting at 10:40am, the LPA along with the 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:

KITCHEN: The LPA observed the kitchen to be clean. Kitchen appliances appeared to be in operable condition. The facility has a sufficient supply of non-perishable and perishable food; properly stored. Refrigerator and dry food pantry were checked for proper labels and expiration dates. The LPA observed knives and sharps in a locked drawer. Cleaning supplies were observed locked an inaccessible at the time of the visit. At 11:06am, the kitchen sink was measured for hot water temperature, and it measured 113.8 degrees Fahrenheit.

BEDROOMS : There are four (4) bedrooms for resident use. Two (2) bedrooms are designated as double occupancy; and two (2) bedrooms are designated as single occupancy. The LPA observed all resident bedrooms to be properly furnished and with sufficient lighting. Additional clean linens and towels for resident use were observed in the hallway closet.