Facility Evaluation Report

On 09/19/25, Licensing Program Analyst (LPA) Villegas conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with Jose Umana as the purpose of the visit was explained. The facility is licensed to operate for (6) non-ambulatory of which (1) may be bedridden resident ages 60 and above, and is approved for (2) hospice residents. Facility fees are current. Liability insurance is active (001200934 Exp: 08/01/26).

The facility is a single-story structure located in a residential neighborhood. It consists of the following: (5) residents' rooms, (2) bathrooms, (1) staff bathroom, a living area, a dining area, a kitchen, an activity room, and an outside seating area. A land line was observed. There are no weapons, no bodies of water on the premises, exits and walkways are free of debris/hazards. All rooms were inspected. Beds and bedding supplies were in operational condition, lighting was provided, and storage for the resident's personal belongings was observed. Bed linens, comforters, and bath towels were available during the visit. Bathrooms were operational with water temperature measured at 105-120 degrees F. Storage areas for personal hygiene and sharps objects were stored and not accessible to residents. The kitchen was inspected, and sufficient perishable and non-perishable food was maintained adequately.

LPA conducted a records review of (4) staff records, (5) resident records, and (5) medication administration records, no discrepancies observed. Medications were centrally stored and properly locked, first aid kit was checked and fully stocked. The last fire was conducted on 06/12/25, (3) fire extinguisher fully charged, carbon monoxide and smoke detectors are interconnected and operational.

Exit interview conducted, and a copy of this report was provided.