Facility Evaluation Report

Licensing Program Analyst (LPA) Daiquiri Boyd arrived at the facility unannounced to conduct a required annual visit. LPA was granted entry by Administrative Assistant(AA) Anne Lorio and LPA explained the purpose of the visit. Licensee/Administrator (AD) Marilen Gonzales was called. (AD) told LPA that she was out of town and could not come to the home and stated AA would assist me. LPA completed the inspection with staff AA, Anne Lorio.

LPA toured the home inside and outside. No exits were found to be obstructed. Temperature of the home was set at 75 degrees F.

Last Fire and Emergency Drill was conducted on 5/18/26 Emergency and Disaster Plan was reviewed by facility on 5/18/26. Fire extinguisher serviced on 2/5/2026. Infection Control Plan was reviewed and last updated and reviewed by facility on 5/18/26.

The home has 5 bedrooms and 2 bathrooms. All bedrooms are nicely furnished with personal affects, beds, tv's, chairs, lighting, dressers, bedside tables, and ceiling fans. Bathrooms delivered hot water at a temperature of 112 degrees F. Fire place is covered with a safety screen.

LPA observed a fresh supply of fruits and vegetables, perishable and non-perishable foods.

LPA observed the home to be in good condition with flooring, walls, lighting, counter tops, fixtures, all in good working order. LPA observed a supply of linens in the hall way closet. All hazardous chemicals and items are kept stored in a locked hall closet. The washer and dryer are kept in the hall way area.

Smoke and carbon monoxide detectors were observed and checked and found to be in working order.

The upstairs area of the home is designated at staff only as LPA verified by observation.

Resident medications and medication records were reviewed. LPA reviewed three resident files and three staff files. (continued on next page)