Facility Evaluation Report

On this day, June 27, 2026, at 10;15 am, Licensing Program Analyst (LPA) Delmundo arrived unannounced to conduct an annual required inspection. LPA was granted entry by Yessica Rivera Ramirez. LPA called and spoke over the phone with Gina Rivera, co-administrator (CO-ADM), and informed the reason for visit. CO-ADM gave permission to the staff to be with LPA while touring the facility. Jamie Rivera-Vallestero, administrator (ADM) arrived at 10:30 am followed by CO-ADM.

LPA started the inspection with the staff and continued with ADM. LPA inspected the kitchen, dining area, living room, bedrooms, bathrooms, garage, side and backyard. Facility has sufficient perishable and non- perishable foods. Central storage for medications, drawer for sharps and cabinets in the garage where cleaning supplies and tools are kept were observed locked.

Fire extinguisher was observed fully charge with tag showed serviced June 26, 2025. Facility has carbon monoxide and smoke detectors that were tested and observed in operating condition on this day. Hot water temperature in the common bathroom was tested, and measured at 109 degrees Fahrenheit. Facility conducts disaster drills every quarter, and records showed last conducted April 17, 2026.

LPA reviewed 3 residents and 5 staff records and interviewed 2 residents. Medications were checked and compared with doctor's orders and LIC622 Centrally Stored Medication and Destruction Records.