Facility Evaluation Report

Licensing Program Analysts (LPAs) Elena Mallett & Luis De Leon, and Licensing Program Manager (LPM) Fernando Fierros conducted an unannounced case management visit to check facility compliance for hospice waiver request per title 22. LPAs was greeted by current Administrator Paula Mera and the purpose for today’s visit was explained.

The facility is in a residential area. The facility is made up of five (5) client bedrooms and one (1) staff room, one (1) full bathroom for residents and one (1) full bathroom for staff, living room, dining room, laundry room, front shaded porch, and backyard, and an attached car garage. There were no body of water observed in the property. The facility has charged fire extinguishers. The building contains central air conditioning and heating.

Resident record review consisted of Physicians Report for six (6) out of six (6) residents, hospice plan for four (4) out (6) residents, and medication written orders for six (6) out of (6) residents. During the visit, Administrator Paula Mera reported the passing of resident R3 the night before 5/8/2025. Administrator will send CCLD a death report for R3 and document cause of death for hospice reason care . Staff roster and staff facility association were reviewed.