Facility Evaluation Report

On 4/2/2025 at 9:30AM, Licensing Program Analysts (LPAs) G. Luk and Y. Brown conducted a Pre-licensing Inspection to verify corrections were made. LPAs met with Licensees/Applicants, Dennis Mendoza and Liwayway Mendoza.

LPAs toured facility including but not limited to resident's bedrooms, bathrooms, living room, kitchen, and outdoor area. LPAs observed bedroom 1 has two beds in good repair and have furniture (a chair, night stand, a lamp or lights sufficient for reading, and a chest of drawers) for 2 residents. LPAs observed bedroom 2 has chest of drawer and have grab bar in bedroom 2's private bathroom toilet installed. LPAs observed bedroom 3's floor near the hallway door has been repaired. LPAs observed facility have mattress pads for the resident's beds. Facility bathrooms have paper towel holders installed. Facility has a land line telephone in operating conditions. LPAs observed LIC610E has been updated to address sections regarding "self-reliant", call button (B), refrigeration medications (F), and confirming location (H). Facility's dementia plan has been updated to address behaviors such as ingestion of toxic chemicals. LPAs observed facility have posted the following: theft & investigative procedures and personal rights.

No issues noted during inspection. LPAs observed that facility is ready to be licensed. This report will be submitted to the Centralized Application Bureau (CAB) and a final review of the application will be conducted. This facility is not yet licensed and is subject to final approval by CAB. Additional requirements may still be required.

Exit interview conducted and a copy of this report provided.