Facility Evaluation Report

On 1/28/2026 at 1:10 PM, Licensing Program Analyst (LPA) Ardalan Gharachorloo arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Administrator, Miriam Moya 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 68 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 114.4 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 06/05/2025 Emergency Disaster Plan was last posted on 10/26/2025. First aid kit was observed to be complete. Fire drill was last conducted on 12/26/2025.

LPA reviewed 4 clients’ records and 5 staff records, and all were complete. A sample of 2 client’s medications were reviewed. The following documents were reviewed during the visit: LIC 500 Personnel Report, Affidavit Regarding Client/Resident Cash Resources, Liability Insurance , Surety Bond,

LIC 610D Emergency Disaster Plan, and administrator certificate.

No deficiencies were cited during this inspection. Exit interview conducted and a copy of this report provided.