Facility Evaluation Report

Licensing Program Analysts (LPA) Erica Mosley arrived at the facility unannounced to conduct a required annual visit and entered the facility at 9:35 a.m. Upon arrival, LPA Mosley was greeted by house manager, Leah Dela Cruz who called the Administrator to inform them of the visit. Parvin Hashemi, Licensee Representative arrived shortly after. The LPA met with Licensee Representative Parvin Hashemi and explained the reason for the visit. The LPA along with Licensee Representative toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations.

INTERVIEWS : From 9:37 a.m. - 9:55 a.m. One (1) staff and three (3) resident interviews were conducted during the inspection. Staff interview revealed that staff are knowledgeable in Resident rights, different forms of abuse, and reporting procedures. Resident interviews revealed that no concerns were noted or voiced at the time of the visit.

COMMON AREAS : At the time of the visit, furniture in the common areas were observed to be in good condition. The facility maintained a comfortable temperature. At 10:10 a.m., smoke detector(s) and carbon monoxide detectors were tested and operational at the time of the visit. The fire extinguisher was observed and fully charged on 09/01/2024. The LPA observed required postings throughout the common space. The last emergency disaster drill took place on 03/07/2025 and conducted monthly. Activities were observed in the common areas. Hygiene items were observed locked and inaccessible in a hallway closet. The facility has a working telephone on the premises. Auditory alarms on all doors were functional at the time of the visit. Entry/exits were free of obstruction.

BEDROOMS: The facility is a single-story residential home with four (4) bedrooms of which three (3) are for resident use and one (1) for staff use. Resident bedrooms are shared, double occupancy bedrooms. The LPA observed resident bedrooms, which were furnished appropriately with clean linens, appropriate furnishings, and sufficient lighting. Staff room remains locked at all time.