Facility Evaluation Report

On 11/04/2025 at 2:15PM, Licensing Program Analyst (LPA) C. Fowler arrived to conducted an unannounced 1-Year Required inspection. LPA met with Caregiver, Marife Siete and explained the purpose of the visit. The Administrator currently holds a certificate (#7033951735) that expired on 11/3/2025 Administrator is waiting for renewed certificate.

LPA toured the facility with Caregiver including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of four (5) total bedrooms which four (4) bedrooms are occupied by clients, and (1) one staff room. There are two (2) full bathrooms. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water. A comfortable temperature is maintained at 75 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. Hot water temperature in the shared clients’ bathroom was measured at 118.2 degrees Fahrenheit. There is a minimum of 7-day supply of non-perishable and 2-day of perishable foods.

Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 10/21/2025. Emergency Disaster Plan was last posted on 10/26/2025. First aid kit was observed to be complete. Fire drill was last conducted on 10/02/2025.