Facility Evaluation Report

On 07/08/2026, Licensing Program Analyst (LPA) M Vega arrived to the facility unannounced to conduct the required Annual Inspection Visit. LPA was greeted by Staff, stated the purpose of the visit and was allowed entry into the facility. LPA met with Staff - Anna Leah Balete, provided a tour of the facility inside and out. Administrator was unable to attend visit.

LPA observed 1 resident in care at the time of visit. Facility is a 3 bedroom 2 bathroom home. Residents bedrooms were observed to have the required lighting and furnishings and were free from odor and free from any passageway obstruction / fire hazards.

Facility temperature was 74 degrees F. Bathrooms were toured and observed to have operational lights, running water, and non- slip floors. Hot water temperature tested at 107.2 degrees F. Trash can with lid and hand washing postings were observed. Medications were observed to be locked in a cabinet in the hallway. Cleaning supplies were observed to be locked in the garage.

LPA toured the kitchen observed the required 7-day supply of non-perishable food and 2- day supply of fresh perishables to be properly stored. Carbon monoxide and smoke detectors were observed to be operational. Fire Extinguisher was observed with a service date of 05/13/2026. First aid kit was observed and contained all required items. The exterior tour of back yard was conducted and found to be free from debris. A covered outdoor seating area was observed for residents in care.

Emergency Disaster Drill logs were observed for staff. LPA observed on the LIC 610D (Emergency Disaster Plan) with emergency numbers and evacuation’s locations was posted in the office.