Facility Evaluation Report

Licensing Program Analyst (LPA) Mayra Cota conducted an unannounced required annual visit. LPA met with Belma Fernandez, Caregiver, and explained the reason for the visit. Administrator, Maria Tavarez, arrived thereafter and assisted with the visit.

The facility is licensed to serve 4 non-ambulatory elderly residents, ages 60 and over, with a Hospice waiver for 2 residents. The facility is operating within the scope of its license. Clients receive services through the Harbor Regional Center. The facility is a single-story home located in a residential area of Lakewood, CA.

LPA and Administrator toured the home and inspected the living room, dining area, kitchen, 4 resident bedrooms, 2 resident bathrooms, 1 staff bedroom with private bathroom, laundry area, attached garage, front yard and back yard.

During today’s visit, LPA observed the following:

Living room and dining area are clean and furniture is in good repair. Both areas have enough seating for residents.

A fireplace was observed and is covered appropriately.

Kitchen counter tops and meal preparation surfaces were observed clean and free of clutter.

Kitchen appliances were observed in operable condition during time of visit.