Facility Evaluation Report

Licensing Program Analyst (LPA) Gabriela Castro conducted an unannounced required annual visit using the Compliance and Regulatory Enforcement (CARE) Tool. LPA was greeted by Venus Calzado and explained the reason for the visit. Michelle Aguirre, Administrator arrived shortly thereafter.

The facility is licensed to serve residents ages sixty (60) and older. The approved capacity is six (6) non-ambulatory residents. The facility has an approved hospice waiver for six (6).

Personal Rights postings (LIC 613C and Ombudsman), Complaint Poster (PUB 475), and nondiscrimination notice were observed in a common area. Oxygen was observed in use in the facility. Required “Oxygen in Use / No Smoking” signs were posted throughout the facility in visible locations. Residents had access to personal space, privacy, and adequate storage. No firearms/weapons were present.

“The facility is located in a residential area and is a single-story home consisting of three (3) resident bedrooms; two (2) restrooms, including one private resident restroom; a living room/dining area; kitchen; laundry room/garage; front yard; and backyard. The facility also includes two (2) offices located within the garage. LPA observed three (3) resident bedrooms, all of which contained the required furnishings, including a bed, mattress, linens, dresser, chair, and adequate lighting. Cleaning supplies and toxic substances were secured in the garage and inaccessible to residents. Bathrooms were clean and equipped with required grab bars in the showers and near toilets, as well as non-skid mats. Hot water temperature measured 114.2°F in bathroom (1) and 116.9°F in bathroom (2), which are within the required range of 105–120°F. Additional linens and towels were available in a hallway cabinet. Smoke and carbon monoxide detectors were operational, and a fully charged fire extinguisher was available in the kitchen/dining area. The backyard provided shaded seating for residents. All passageways and exits were observed to be clear and unobstructed.