Facility Evaluation Report

On 7/27/2026 at 9:00 AM, Licensing Program Analyst (LPA) A. Gomez arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Caregiver, Angelo DeLa Cruz and explained the purpose of the visit. Licensee, Christine Soriano arrived at 11:03am. The facility’s fire clearance was approved for 6 non-ambulatory.

LPA toured facility with caregiver including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 6 total bedrooms which 5 bedrooms are occupied by the residents and 1 bedroom is occupied by staff. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 72 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathrooms was measured at 112.1 and 110.8 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of nonperishable and 2-day of perishable foods. LPA observed centrally stored medication and sharps secured.

Smoke detectors and carbon monoxide detector were in operating condition during visit. Fire extinguisher was last serviced on 4/23/2026. Emergency Disaster Plan was last posted on 4/27/2026. Emergency Disaster Drill conducted 5/4/2026. First aid kit was observed to be complete.

LPA reviewed 5 residents records. LPA reviewed 3 staff records and 3 of 3 have current first aid training and associated to the facility.

Updated copies of the following documents were requested for facility file and are to be mail to CCL by 9/1/2026:

LIC 308 Designation of Administrative Responsibility

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