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 six (6) residents present. LPA was greeted at the door by Administrator, Iris Van Kralingen and at this time, the reason for the visit was explained. Entrance interview conducted.

At 9:54am, the LPA along with the Administrator 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. The following was observed:

KITCHEN: The LPA inspected the kitchen/food service area at 9:55am. Knives and sharps were observed in a locked drawer inaccessible to residents in care. Kitchen appliances were in operable condition. The facility has a sufficient supply of perishable and non-perishable food; properly stored. Refrigerator and food pantry were checked for proper labels and expiration dates.

COMMON AREAS: This includes the living room and dining room area. The common areas were furnished appropriately, and all furniture was observed to be in good condition at the time of the visit. The facility maintained a comfortable temperature. LPA observed required postings throughout the common space. Activities were observed in the living room. There is a working telephone on premises. LPA observed functioning auditory alarms at the time of the visit. No obstructions or hazards were observed inside or out.