Facility Evaluation Report

Licensing Program Analyst (LPA) Gabriela Castro conducted an unannounced required annual inspection using the Compliance and Regulatory Enforcement (CARE) Tool. LPA was greeted by Sonia De La Cruz, who was informed of the purpose of the visit. Administrators Michelle Navarro and Nino Navarro arrived shortly thereafter.

The facility’s fire clearance is approved for six (6) residents over the age of 59. Bedroom #1 is approved for one (1) bedridden resident. Bedroom #3 is approved for two (2) non-ambulatory residents. Bedrooms #5 and #6 are each approved for one (1) non-ambulatory resident, and Bedroom #4 is approved for one (1) ambulatory resident. The facility may retain no more than five (5) hospice residents.

At the time of inspection, three (3) residents were under hospice care.

Personal Rights postings (LIC 613C and Ombudsman), Complaint Poster (PUB 475), and nondiscrimination notice were observed in a common area. Residents had access to personal space, privacy, and adequate storage. No firearms/weapons were present.

Required “Oxygen in Use” signage was posted in visible locations throughout the facility in accordance with safety requirements.

The facility is located in a residential neighborhood and is a single-story home consisting of six (6) bedrooms, three (3) bathrooms (one of which is a private shared bathroom), a living room, family room, kitchen, dining area, attached garage, front yard, and backyard. LPA observed five (5) resident bedrooms, with one (1) bedroom designated for staff use. All bedrooms observed contained the required furnishings, including a bed, mattress, linens, dresser, chair, and adequate lighting.