Facility Evaluation Report

On 3/23/2026 starting 9:00 AM, Licensing Program Analyst (LPA) A. Gomez arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Caregiver, Luz Gutierrez and explained the purpose of the visit. The facility’s fire clearance was approved for all six (6) residents may be non-ambulatory. There were 2 staff and 4 residents present during inspection. Administrator, Quennie Balmeo cert #7033883740 EXP: 6/14/2026 arrived at 11:20 AM.

LPA toured facility with Caregiver including but not limited to 6 bedrooms, 3 bathrooms, kitchen, common area and backyard. The facility consists of 6 total bedrooms which 5 bedrooms are for residents and 1 bedroom is for staff. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 69 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in residents’ shared bathroom was measured at 119.9 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. Centrally stored medication were unlocked and sharps were locked and inaccessible to residents.

Three smoke detectors and carbon monoxide detector were in operating condition during visit. Fire extinguisher was last serviced on 1/20/2026 . Emergency Disaster Plan was last posted on 1/15/2026. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 1/16/2026. LPA requested for Emergency Disaster Plan to be updated in detail and submitted to the department as well as posted.

At 12:15 PM, LPA reviewed 4 residents records. LPA advised Administrator to have residents responsible parties sign their annual appraisal of needs and services. At 12:35 PM LPA reviewed 3 staff records and 3 of 3 have current first aid training and are associated to the facility.