Facility Evaluation Report

At 9:30a.m., Licensing Program Analyst (LPA) Antonia Alvizar-Ettima conducted an unannounced Required One (1) year inspection to the facility. LPA met with caregivers that granted entry to the facility and explained the reason for the visit. Later, Administrator joined today’s visit.

At approximately 12:05p.m., LPA and Administrator conducted a physical plant tour inside and out. During the tour, LPA observed that the facility is a home located in a residential community. Required postings were observed in the entry area. The smoke alarms are operational, they are in each bedroom and hallways. There are carbon monoxide detectors that function properly. The fire extinguishers are located throughout the facility. The charge date is 02/20/26. Fire/Earthquake emergency drill was last conducted on 06/02/26. During this visit the facility is 78 degrees Fahrenheit. The facility is fire cleared for six (6) non-ambulatory residents; two (2) hospice waiver current census is five (5) residents.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following:

Kitchen: LPA observed kitchen appliances and fixtures were functional. The kitchen has a working gas stove, faucet, freezer, refrigerator, and microwave. LPA found at least two (2) days perishable and seven (7) days non-perishable food at the facility that is properly stored. Frozen foods are wrapped, dated, and stored properly as well. Knives were stored in a locked drawer in the kitchen. The menu was posted for review, snacks and beverages are always available for the residents in the facility. Food storage and preparation areas are clean and inaccessible to pests. Garbage cans have tight fitting covers. Cleaning supplies, pesticides, and toxic cleaning supplies were stored and locked away in the kitchen under the sink.