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25 | Licensing Program Analyst (LPA) M. Flores arrived at the facility unannounced to conduct a required annual visit. LPA explained the purpose of the visit and was granted entry by staff and House Manager, Rosa Guzman (S1). A few minutes later, House Manager, Virginia Jimenez (S2) arrived at the facility. This annual visit was completed with S1 and S2, as approved by Administrator, Elizabeth Perera.
The residence was set at 77 degrees F temperature and free of passageway obstructions inside and outside. LPA observed six bedrooms in the residence. Residents' rooms were toured and inspected. Rooms were found to be clean, and furnishing was in good condition. Hot water temperature was measured at 107.7 degrees F.
Kitchen toured, supply of food observed, and food stored properly for perishable and nonperishable. Knives are kept locked in the kitchen area. Medication is kept locked in the medication storage office. Cleaning supplies were locked in the laundry room and storage room. Smoke detectors and carbon monoxide are dual detectors, they were checked and operating. Fire extinguisher was charged and was serviced on 9/06/2023. First Aid kit is fully equipped.
There was outdoor seating for the residents. Outdoor area was clean and free of obstruction.
An exit interview was conducted, and a copy of this report was provided to S2 whose signature confirms receipt.
LPA requested the following updated forms faxed to CCLD by 12/22/23: Designation of Facility Responsibility (LIC308), Administrative Organization (LIC309), Personnel Report (LIC 500), Proof of current Liability Coverage. |