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25 | Licensing Program Analyst(s)(LPA) Sanjay Vaid conducted an unannounced annual visit to the facility at 12:40 pm. LPA met with Rosalie Sandoval administrator and explained the reason for the visit. Obtained copy of staff and resident rosters.
The CARE tools were used to conduct the annual investigation for the facility.
The facility is licensed to serve 40 non-ambulatory residents ages 60 and over with an approved hospice waiver for 5 residents. The facility is a 2-story building located in a residential area, it has 20 shared rooms, an activity room, a dining room with kitchenette, a medication room, a cover balcony in the second floor, and a back outdoor area. Facility does not have a kitchen and per the plan of operation they receive food prepared in their sister facility for all resident meals.
LPA Vaid conducted a tour of the facility with Rosalie Sandoval and observed the following:
Dining area is clean. Kitchenette's drawers/cabinets were observed, cleaning supplies were observed in a cabinet with a lock and inaccessible to the residents. Activity room was observed. Five resident rooms were observed, room #70, 75, 87, 88, 89. Each room has sufficient lighting, and required furniture and bedding supplies. A bathroom was observed in each bedroom and water temperature was tested between 108.9 – 116.4 degrees F., which is within the required 105-120 degrees F. Outdoor area has shaded sitting areas. Last fire inspections were conducted on 04/02/24. Last fire drill was conducted on 04/10/24, earthquake drills was conducted on 04/25/24. Fire Extinguishers were observed and last checked on 6/30/23. Copy of Surety Bond was examined and has coverage up to $8000.00 per incident dated 01/15/2016.
A copy of liability insurance was obtained expires 05/08/2025.
Due to shortage of time,the staff and residents were not interviewed. The following Care Tools were completed: Operational Requirements, Physical Plant and Environment Safety, Staffing, Residents rights- Information, Planned Activities, and Food Service.
No deficiencies were noted on today’s visit. Exit interview was conducted with Rosalie Sandoval administrator and a copy of this report, were provided. |