Facility Evaluation Report

Licensing Program Analysts (LPAs), Martha Arroyo Valeria Conway conducted a pre-licensing visit to this property at 9:00 a.m. on 01/19/2024 and met with Applicant Representative Julie Ann Arcenas as this is a change of ownership application from Bernadette Home Care III #567609985 to Happy Home Villa #565850405. The applicant has obtained fire clearance for a total capacity of six (6) non-ambulatory residents in bedrooms #1 - #4. The facility has a dementia program in place.

LPAs inspected facility for Fire Safety, Personal Accommodations and Services, and Food Service. At 9:26 a.m., all hard-wired smoke alarms and carbon monoxide detectors were tested and function properly. LPAs observed two (2) fire extinguisher to be new and fully charged on 06/15/2023.

There are two (2) single occupancy bedrooms and two (2) double occupancy bedrooms for resident use and one (1) staff room. Each bedroom is equipped with clean mattresses, pillows, and bedding. There is a closet in the hallway with a sufficient supply of linens, including blankets, bath towels and wash cloths. Bedrooms have sufficient lighting. The facility has two (2) bathrooms for resident use. Resident bathrooms contained appropriate non-skid mats and grab bars. Bathrooms have sufficient paper products. Hot water temperature was measured in both bathrooms, and they measured between 105- and 120-degrees Fahrenheit. LPAs observed trash cans with tight fitting lids at the time of the visit.

LPAs toured the kitchen area at 9:20 a.m. The facility has at least seven (7) day supply of non-perishable food and two (2) days perishable food. Appliances and all equipment appear to be clean and in good repair. Kitchen knives and sharps were observed in a drawer next to the kitchen sink locked and inaccessible. The kitchen has a sufficient supply of plates, cups, cookware and utensils.