Facility Evaluation Report

On 12/23/25, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct an annual visit.

introduce self, stated the purpose of the visit and met Licensee/ Administrator (L1) Socorro Ann Telmo. LPA toured facility with L1. All residents were present during inspection of which 3 residents are receiving hospice care. Residents were observed sitting in the common areas and in the bedroom during tour.

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. All residents’ and a sample of staff files were reviewed. An adequate supply of perishable and non-perishable food was observed. Refrigerator temperature is maintained at 36 degrees F and freezer at 0 degrees F. Chemicals were observed locked under kitchen sink. Knives were observed locked under kitchen counter. Medications were observed locked in kitchen shelves. MARs were reviewed. First aid kit observed with required items. Fire extinguisher was observed with a service date of: 04/19/25. All bedrooms were observed to have the required furnishings and with adequate lightning. Extra linens were observed. The bathrooms were toured and observed with non-skid mat and grabbed bars. Outside of facility toured and observed to be free of debris. Side gate observed self-closing and self-latching. Adequate outdoor seating was available for residents. Carbon monoxide and smoke detector operational during visit.

A deficiency is being cited, per California Code of Regulations, Title 22, Division 6, see attached Lic 809D

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