Facility Evaluation Report

On 6/19/25 an unannounced annual visit was conducted by Licensing Program Analyst (LPA) Perchui Milena Khurshudyan. Upon arrival, LPA met with the facility Administrator Elena Angustia, who granted access to the facility. LPA introduced herself by showing her badge and explained the reason for the visit. LPA Khurshudyan reviewed the required postings on a wall throughout the facility. The inspection tool was used to complete today's visit.

During today's visit, LPA conducted a physical plant walk through at approximately 10:55am, to ensure that the facility is in compliance with rules and regulations under California Code of Regulations, Title 22.The following was observed: The facility is a single-story home and is licensed for capacity of six (6) residents, of which six (6) may be non-ambulatory and of which fire clearance for one (1) Bedridden. Facility also has a hospice waiver for one (1) resident. There are five (5) bedrooms designated for residents’ use. All bedrooms observed to be appropriately furnished and have appropriate lighting. There are two (2) bathrooms in the facility designated for residents’ and staff use. LPA observed bathrooms have soap, paper towels and hand washing signs. The hot water temperature measured at 11:15am to be 123.1°F. Extra towels and linens were readily available in the linen closet located in the hallway. There are grab bars for each toilet and shower, bathrooms have non-skid mats. All trash cans in bathrooms had fitted lids to protect from cross contamination. LPA observed facility alarms were present on all exit doors and signals were operational.

SMOKE DETECTORS/CARBON MONOXIDE. The smoke detectors and carbon monoxide are hard wired, inter-connected and were located throughout the facility. At 12:30pm they were tested and observed to be operational. The facility has two (2) fire extinguishers that was last purchased on 7/16/2024.