Facility Evaluation Report

Licensing Program Analyst (LPA) Glenn Trueman conducted the unannounced annual inspection on 7/13/26. LPA met with Staff Vangie Mendoza and explained the purpose of the visit.

Shortly thereafter Administrator, Alan Buan arrived.

The facility is licensed to serve (6) non-ambulatory residents, ages 60 and over. A hospice waiver has been approved for three residents. There are currently 5 residents residing in the facility.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today.

Staff are continuing to follow their Infection Control Plan and using appropriate hand hygiene and wearing gloves when necessary. Staff are adhering to operational requirements. The facility is a single-story home with four resident bedrooms, 1 staff room, 2 bathrooms, an open living room, dining room, and kitchen. The laundry machines are located in the attached garage. The bedrooms are equipped with the necessary furniture and storage space. There are no pools or bodies of water on the premises. Knives and cleaning solutions are locked and inaccessible to clients. The water temperature was measured within the required range of 105-120 degrees F. Sufficient food supplies were observed. LPA reviewed 8 personnel files. The Administrator's certificate expires on 1/8/28. Staff hold current First Aid & CPR certifications and have completed the required annual training hours. LPA reviewed (5) resident files and medications. The files have the required documentation, and staff are administering the medications as prescribed. There are no residents with a restricted or prohibited health condition. The facility is conducting drills at least quarterly.

Medication for resident was not administered for AM dosage today 7/13/26.

Technical Advisory (TA) was also given regarding tear in window screens.

An exit interview was held. A copy of this report and appeal rights were provided to the administrator.