Facility Evaluation Report

Licensing Program Analyst (LPA) Martha Arroyo arrived at the facility unannounced for a required one-year annual inspection today. The last annual conducted at this facility was on 05/26/2023. When the LPA arrived, there were two (2) staff and four (4) residents present. LPA met with staff and the reason for the visit was explained. The Licensee Representative arrived at 9:30 a.m. Entrance interview.

At 9:31 a.m., the LPA along with the Licensee Representative 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.

KITCHEN: The LPA inspected the kitchen/food service area at 9:46 a.m. Kitchen appliances appeared clean and were in operable condition at the time of the visit. The facility has a sufficient supply of perishable and non-perishable food. Food labels were inspected and checked for dates and expiration dates. The knives and sharps were observed locked and inaccessible to residents in care. At 9:49 a.m., the hot water temperature was measured in the kitchen sink, and it measured 112.2 degrees Fahrenheit.

COMMON AREAS: At the time of the visit, the living room and dining room furniture was observed to be in good condition. The facility maintained a comfortable temperature. At 9:51 a.m., the smoke detector(s) and carbon monoxide detector were tested and operational at the time of the visit. The fire extinguisher was observed and fully charged on 07/12/2024. LPA observed required postings throughout the common space. There is a working telephone on premises. Activities for resident use were observed in the living room.