Facility Evaluation Report

On 03/10/26, Licensing Program Analysts (LPA) M. Yang arrived unannounced to conduct an annual visit. LPA introduce self, stated the purpose of the visit and met with staff Roxanne Chavez. All three residents were present during inspection. Licensee/Administrator (L1) Lina Juarez was called and arrived shortly during visit. LPA toured facility with L1.

The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside or outside. Fire extinguisher was observed with a service date of 02/24/26. Temperature maintained for refrigerator at 33 degrees F and freezer at -4 degrees F. Medications observed locked in kitchen shelf. MAR was reviewed. An adequate supply of perishable and non-perishable food was observed. Cleaning supplies observed stored under kitchen sink, under bathroom sink, in laundry room cabinet and garage cabinet locked. Extra linens observed in garage cabinets.

All bedrooms were observed to have required furnishings and with adequate lighting. All bathrooms are observed with securely fastened grab bars and non-skid mats. Hot water tested maintained at 106.3 and 107.2 degrees F in vacant master bathroom and at 110.2 degrees F in hall bathroom. Outside of facility toured and observed to be free of debris. Adequate outdoor seating observed for residents. Side gate was observed free of debris. Carbon monoxide and smoke detectors were tested and observed to be operational during visit. All residents’ and sample of staff files were reviewed to have all required documents.

A deficiency is being cited on the attached Lic 809D in accordance to California Code of Regulations, Title 22, Division 6.

Exit Interview conducted. LPA received copies of Lic 308, Lic 500, Lic 610E, Lic 9020, current Administrator Certificate, and current liability insurance during visit. A copy of this report and appeal rights was provided to the Licensee, whose signature on this form confirms receipt of this report.