Facility Evaluation Report

Licensing Program Analyst (LPA) Cynthia Chan conducted the required annual inspection on 7/11/25. LPA arrived unannounced and met with the staff, Edith Francisco. The reason for the visit was explained. The Assistant Administrator, Mirafy Lopez, arrived shortly after to assist with the visit. The facility is licensed for (4) non-ambulatory adults, ages 18 - 59, of which 1 may be bedridden in bedroom #3. There is a hospice waiver approved for 1 client.

LPA inspected the facility using the Compliance and Regulatory Enforcement (CARE) tools.

The facility consists of 3 client bedrooms, 1 administrator's office, 2 bathrooms, living room, dining room, and kitchen, laundry room, and detached garage. The spacious outdoor has a shaded area. Each client has their own bedroom with appropriate furniture and storage space. There are extra linens and hygiene supplies. Facility has interconnected smoke and carbon monoxide combo detectors. Knives, cleaning solutions, and disinfectants are locked. The hot water temperature was measured between the required range of 105-120 degrees F. Food supplies of 2 day perishable and a week of non-perishable are observed. Staff are providing care and supervision to meet the clients' needs and assisting in activities of daily living. Staff are continuing to follow their infection control plan while handling clients. There is sufficient staffing to assist the clients with one overnight staff awake to supervise clients. Staff are all fingerprint cleared and associated to the facility. LPA reviewed records for 3 staff and 3 Clients and all required forms are present. Administrator's (Luis Gonzales) certificate expires on 8/20/25. Facility staff have current CPR & First Aid certificates. There are 2 clients with restricted health conditions, and staff have received training from a licensed professional to provide care. Medications are centrally locked and no discrepancies were found. The facility has the updated emergency and disaster plan and conducting emergency drills monthly.

No deficiencies were observed today. An exit interview was held. A copy of this report was given to M. Lopez.