Facility Evaluation Report

Licensing Program Analyst (LPA) Vaid conducted an unannounced annual inspection visit. LPA was allowed entry by Judy Alba caregiver, Administrator was notified and house manager Bioston arrived shortly after to assist with the visit. Facility is licensed to serve six (6) non-ambulatory elderly residents, ages 60 and above. No bedridden allowed. Hospice waiver approved for six (6) residents.

During the visit, CARE tool was used, a tour of the facility was conducted, food supply/medication were reviewed, staff/residents were interviewed, and staff/residents’ records were reviewed.

The facility is located in a residential neighborhood. The facility consisted of four (4) bedrooms approved for non-ambulatory residents, two (2) bathrooms, kitchen, dining area, laundry area, and living room with a TV. All the rooms were furnished with appropriate furniture for residents’ comfort. The bathrooms were furnished with grab bars and nonskid surfaces. Common areas were observed for the ability to safely serve the needs of the residents. Hot water temperature was measuring 105-120 degrees Fahrenheit. Adequate linen and personal hygiene supplies were observed. No pools and bodies of water on the premises. Facility maintained a comfortable temperature for residents. Auditory alarm devices to monitor exits were operable. Interior and exterior space are available to permit residents to wander freely and safely. Sufficient supplies of perishable and nonperishable foods were observed. Knives, tools, sharp items were inaccessible to residents. Smoke detectors and carbon monoxide detectors were operable. Fire extinguishers' last service was 04/13/2026 and were fully charged. Medication and residents'/ staff records were centrally stored in a locked cabinet and inaccessible to residents. Toxic substances were inaccessible to residents. House manager Barbara Boiston certificate expires 09/06/26. Insurance liability expires 06/27/2027.

No deficiencies were observed per California Code of Regulations, Title 22. An exit was presented to Barbara Bioston.