Facility Evaluation Report

Licensing Program Analyst (LPA) Martha Arroyo arrived at the facility unannounced to conduct a required annual visit today at 9:30am. Upon arrival, the facility was empty. The LPA contacted Administrator via telephone and the reason for the visit was explained. Staff arrived at the facility at approximately 9:55am and the Administrator, Maria Ibarra arrived at 10:10am. The four (4) residents were at the day program at the time of the visit. Entrance interview conducted.

Starting at 10:12am, 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 seven (7) days non-perishable and two (2) days perishable food; properly stored. Refrigerator and dry food pantry were checked for proper labels and expiration dates. Knives and sharps were observed in a locked cabinet inaccessible to residents in care. At 10:15am, the kitchen sink was measured for hot water temperature, and it measured 111. 3 degrees Fahrenheit.

BEDROOMS : There are three (3) bedrooms for resident use and one (1) bedroom designated for staff only. One (1) resident bedroom is designated as double occupancy; and two (2) resident bedrooms are designated as single occupancy. The LPA observed all resident bedrooms to be properly furnished with a bed, appropriate and adequate bedding, nightstand, and sufficient lighting. Additional clean linens and towels were observed for resident use.