Facility Evaluation Report

Licensing Program Analyst (LPA) Jill Nakagawa arrived unannounced to conduct an Annual required – 1 yr. inspection on 5/19/2023 and met with Administrator, Stanford Madriaga. There are 4 residents living in the home. There were 3 staff present at the time of inspection.

LPA toured the facility at 2:35 PM and facility was found to be clean and at a comfortable temperature with all exits free from obstruction. The home does not have any bodies of water and Administrator states that there are no weapons in the home. There was a sufficient supply of both perishable and nonperishable food as required by Title 22 Regulations. Food stored in the kitchen refrigerator was properly stored. Toxins are stored in a locked closet. There was a supply of hygiene products and paper products available for residents. Facility is equipped with auditory alarms at all exit doors. Bathrooms were equipped with necessary grab bars, non-slip floors/mats and paper towels. All bedrooms have lighting & appropriate furnishings.

File review was initiated. Resident and staff files were reviewed. Medication reviewed. Staff have required First Aid/CPR certificates expiring 2/6/25. Administrator Certificate for Administrator, Stanford Madriaga #6031652720 expires June 24, 2024. Required postings were observed.

Exit interview conducted with Administrator, Stanford Madriaga.