Facility Evaluation Report

On 11/16/24 Licensing Program Analyst (LPA) M. Garza arrived unannounced for an annual inspection visit. LPA contacted Administrator, Dale Martinez. Licensee, Lupe Martinez, Administrator and Direct Care Staff, Kyrstyn Martinez arrived at the facility. LPA explained reason for visit and was permitted entry into the facility. There are currently no residents residing at the facility.

LPA toured the facility inside and out. Pathways and doors were clear and free from obstruction. Facility was clean and without odor. Common areas were clean, adequately furnished, and adequately lit. Smoke detectors and carbon monoxide detectors were present and operational at time of visit. Water temperature measured at 116.4 degrees F. Resident rooms observed to have the required furnishings and with adequate lighting.

LPA requested the following documents to be submitted to CCL by 11/22/24: current copy of Administrator’s Certificate, Administrator Organization (LIC 309), Designation of Administrative Responsibility (LIC 308), Emergency Disaster Plan (LIC 610-D), Personnel Report (LIC 500) in order to update the facility file.

No deficiencies were cited during todays visit.Exit interview completed with Licensee, Administrator and Direct Care Staff. A copy of this report provided.