Facility Evaluation Report

Licensing Program Analyst (LPA) Jill Nakagawa conducted an unannounced Post-Licensing inspection on 11/15/2022 at approximately 3:00 PM. LPA is conducting visit with Dedre Rodriguez (DR), Program Manager. There are currently 13 residents in care. There were 3 staff on site at the time of inspection.

The amount of fresh and nonperishable foods appeared to be within regulation. Medications and toxins are locked in Staff Room. Sharps and Chemicals are also locked in kitchen. Bathrooms were equipped with necessary grab bars and non-slip floors/mats and appeared to have sufficient hygiene products. LPA observed that resident rooms were furnished per regulations. Fire extinguishers were last inspected 6/23/22 (2 extinguishers) and 2 Carbon Monoxide Detectors were observed and operational.

LPA observed required postings regarding COVID-19 precautions throughout the facility and required visitation postings. Facility is screening visitors at the front door. LPA observed a sufficient supply of PPE equipment. The facility staff was observed wearing masks during the tour of main entrance, doors, common areas, dining room and kitchen area. LPA reviewed documents in 2 resident files. Program Manager stated disaster drills are conducted quarterly. Administrator's Certificate 6027846735 expires 07/02/24.

No deficiencies cited during today's inspection.

Exit interview conducted with Program Manager,