Facility Evaluation Report

On 3/1/2022, Licensing Program Analysts (LPAs) L. Ibo & K. Nguyen arrived unannounced pre-licensing for change of ownership. LPAs met with Administrator Elena Mihale.Licensee Antonia Arellano arrived around 6:45PM. LPAs explained the purpose of the visit. No residents observed during the visit.

Facility has an approved fire clearance for 6 non ambulatory residents. Last fire inspection was conducted on 1/22/2022. LPAs inspected the facility including but not limited to 6 resident rooms, 1 staff room, 1 staff bathroom and 3 residents’ bathrooms, common areas, kitchen, dining, family room, living room, courtyard area and outside areas.

LPAs observed the following during the inspection:

Living is unorganized with the following items; kids’ trampoline, empty boxes, cluttered shoes

Kitchen area; kitchen knives are placed on the counter; rotten fruits at the kitchen counter, unorganized and cluttered children’s toys & children’s supply, empty boxes, garbage’s, unlocked medication, flower base and old flowers with cloudy water, sink area has dirty dishes & pots and pans , dog food and dog water bowl located on the hallway

Family room; cluttered children’s toys, basket full of toys that is blocking kitchen hallway, couch pillows was unorganized

Bedroom #1; the only set up room for licensing inspection, with one bed, lamp shade, drawer, closet has multiple curtain rods and detached bedrail, lamps, unplugged TV, multiple comforter sets