Routine inspection·February 23, 2023

Licensing Program Analyst (LPA) Avelina Martinez made an unannounced visit to this facility to conduct an annual inspection on 02/23/2023 at 1:18 PM. LPA Martinez met with Emerlinda Siebenthal and stated the purpose of today’s visit. LPA inspected the physical plant including but not limited to the kitchen, dining room, resident bedrooms; resident bathrooms, laundry room, activity room, and outside courtyards of the facility to ensure compliance with Title 22 regulations. Administrator holds current certificate. The facility is licensed for six non-ambulatory residents. There are currently six residents who reside at this facility. The facility has an approved hospice waiver for two. LPA Martinez toured the facility with the Emerlinda Siebenthal on 02/23/2023 at 2:00 PM. The facility has one main Covid-19 screening entry point, and has a supply of PPE. The facility also has an infection control plan. The facility is sanitary and clean. The facility common areas are clean and furnished. The facility water temperature measured at 105 degrees. The facility temperature measured at 76 degrees. The fire extinguishers are in good repair. The emergency exit gate is in good repair. The facility has an adequate food supply. The facility laundry room is in good repair. The facility has a locked closet for medications, and the first aid is in good repair. Resident rooms and bathrooms are in good repair and furnished. There were no deficiencies cited at this annual visit. An exit interview was conducted, and a copy of this report was provided to the Licensee at the end of the visit.