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25 | Licensing Program Analyst (LPA), Kristina Ryan, conducted an unannounced visit to verify information on the updated facility sketch provided to the department on July 6, 2021. LPA identified herself, stated the purpose of the visit and was granted entry by Caregiver, Raymond Abedoza. LPA met with Administrator, Wilma Cabrera. The facility is currently licensed to serve six (6) residents, five (5) of whom are non-ambulatory and one (1) bedridden resident in bedroom # 5.
During today's visit, LPA conducted a tour of the facility with Raymond Abedoza. The facility desires to eliminate the shared room previously designated by the facility, as well as change its license status from five (5) non-ambulatory residents to four (4) non-ambulatory residents. The facility will retain its license to serve one (1) bedridden resident in bedroom # 5. Currently, The facility is not in compliance with the facility sketch provided to Community Care Licensing, as the employee room designated on the facility sketch is bedroom #4, and currently the employee room is in bedroom #2. Currently, Bedroom #4 is unoccupied. The administrator understands that the rooms being used must be correctly reflected on the facility sketch. The administrator will make the appropriate corrections for a follow-up unannounced inspection.
An exit interview was conducted with Administrator, Wilma Cabrera, to whom a copy of this report, and the Licensee/Appeal Rights (9058 01/16) were provided via e-mail. An electronic read receipt verifies receipt of these documents.
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