Facility Evaluation Report

On 5/5/22 at 11:40 AM, Licensing Program Analysts (LPA) C. Lin arrived unannounced to conduct the 2nd Pre-licensing Required inspection for changing of ownership. LPA met with applicant, Tessa Cruz and explained the purpose of the visit. The facility currently has 9 residents.

LPA toured facility, inspected deficiencies cited on 4/21/22, and confirmed that deficiencies have been corrected. Hot water temperature was 120 degrees F.. First Aide kit was observed to be purchased. Laundry detergent and cleaning supplies were observed locked inside the laundry room. Medication, knives, and scissors were observed locked in the kitchen. A bland new dresser was replaced. Alarm was observed to be installed on both doors exit to the backyard.

Component III Orientation had been conducted previously with Juliet Pacaldo and Tessa Cruz by LPAs C. Lin and L. Fici on 4/21/22, therefore it's waived at this time.

No issues noted during inspection. LPA observed that facility is ready to be licensed. This report will be submitted to the Central Applications Unit (CAU) and a final review of the application will be conducted. This facility is not yet licensed, and is subject to final approval by CAU. Additional requirements may still be required.

Exit interview conducted with applicant and a copy of this report provided.