Facility Evaluation Report

Licensing Program Analyst (LPA) Elsie Campos arrived at the facility announced at approximately 9:40 a.m. to conduct a pre-licensing inspection. The LPA met with applicant Karen Rosales. This is a new facility application for (6) six residents’, rooms are cleared (6) six non-ambulatory residents at this time. The fire clearance was granted on 2/23/2023. Component III was waived as the applicant currently operates (5) five other Residential Care Facilities for the Elderly (RCFE)’s that are currently in good standing. Applicant has attended Component III in the past and is RCFE administrator certified.

At 10:05 p.m., the LPA toured the physical plant areas inside and outside with applicant to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations.

KITCHEN : Kitchen knives are stored locked and inaccessible in a kitchen cabinet on the left-hand side of the kitchen sink. The supply of perishable and nonperishable food is adequate. The supply of dishes is adequate. Appliances in the kitchen were clean and appeared functional. There is an adequate supply of emergency food and water. The Administrator was advised to use a lock with key or magnetic lock rather than a child proof locking device for the sharps, medications and chemicals as those could potentially be opened without a the use of a key.

BEDROOMS : There are (6) six bedrooms in the facility; the facility has (4) four private bedrooms for resident use, (1) shared bedroom for resident use and (1) one staff room. The staff room is kept locked. All resident rooms have direct access to the outside. Lighting in the rooms appeared adequate. (3) three out of (5) five resident rooms and (1) staff room were set up with beds, night stands, lamps, chests of drawers, chairs and closet space. Administrator indicated they would be furnishing the additional rooms immediately.

BATHROOMS : There are (2) two full bathrooms and (1) one half bath for resident use; the half bathroom near the entrance of the main hallway at the entrance of the home is designated for and guests. Staff have a private staff bathroom located next to the Staff room. The (1) one of (2) resident showers are equipped with nonskid surfaces and available nonskid mats. ** Continued on LIC 809-C**