Facility Evaluation Report

On 05/20/2025 at 11:05 AM, Licensing Program Analyst (LPA) Ardalan Gharachorloo arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Administrator, Ryan Jayson Carvajal and explained the purpose of the visit.

LPA toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. All outdoor and indoor passageways are kept free of obstruction.There are no bodies of water. A comfortable temperature for clients is maintained at 71 degree Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the clients. Hot water temperature in the shared clients’ bathroom was measured at 107.5 degree Fahrenheit. All toilets, hand washing, and bathing are safe, sanitary and in operating condition. The supply of extra hygiene was available for clients. There is a minimum of one-week supply of non-perishables and 2-day perishables food supply.

Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 11/18/2024. Emergency Disaster Plan was last posted on 06/21/2024. First aid kit was observed to be complete. Fire drill was last conducted on 04/25/2025.

At 12:15 PM, LPA reviewed 5 clients’ records and 5 staff records. A sample of 5 client’s medications were reviewed. The following documents were reviewed during the visit: LIC 500 Personnel Report, LIC 308 Designation of Administrative Responsibility, LIC 400 Affidavit Regarding Client/Resident Cash Resources ,LIC 402 Surety Bond, LIC 610D Emergency Disaster Plan and a current Administrator's Certificate.