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 four (4) residents. The staff contacted the Administrator via telephone and explained the reason for the visit. The Administrator, Norma Zanders arrived during the inspection. Entrance interview conducted.

Starting at 9:35am, the LPA along with staff 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. Knives and sharps were observed locked an inaccessible under the kitchen sink. At 09:42am, the kitchen sink was measured for hot water temperature, and it measured 112. 4 degrees Fahrenheit.

BEDROOMS : There are three (3) bedrooms for resident use and one (1) bedroom designated for staff only. Two (2) resident bedrooms are designated as double occupancy; and one (1) resident bedroom is 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 a closet.