Routine inspection·May 17, 2024

Licensing Program Analyst (LPA) Araceli Canela arrived unannounced to conduct a Required - 1 Year inspection and met with, Administrator, Mary Jane Mendoza. There are currently 5 residents living in this facility. This facility is licensed for 6 non-ambulatory residents, with hospice waiver approved for 2 of the residents and none of the residents are approved for bedridden. LPA toured facility and grounds and observed facility was found to be clean at a comfortable temperature with all exits free from obstruction. Resident rooms have the required furnishings and linens. Medications are stored locked in cabinet in the living room area along with resident files. Facility has at least two days of perishable and one week of non-perishable foods. Fire Extinguisher was found to be charged, and serviced. Smoke alarms and Carbon monoxide detector are operational. Facility last fire drill was conducted on May 1, 2024. Water temperature in bathrooms measured within the range of 105 to 120 degrees F allowed per regulation. Extra hygiene products and linens were available. LPA reviewed resident and staff files and staff files had the required training and proof of CPR/1st Aid expiring 6/6/2025. Resident files were reviewed Continue report see LIC809-C Licensee/Administrator to submit the current following documents by 6/15/2024: · LIC 308 Designation of Facility Responsibility · LIC 500 Personnel Report · LIC 610E Emergency Disaster Plan · LIC 9020 Register of Facility Residents Infection Control Plan of Operation (If changes) Liability Insurance No citations issued during todays visit.