Facility Evaluation Report

On 09/18/25, Licensing Program Analysts (LPA) Villegas conducted an unannounced annual required visit using the CARE Inspection Tool. LPAs met with administrator Leslie Bauguess and explained the purpose of today’s visit. The facility is licensed to operate for (6) elderly residents of which (5) may be non-ambulatory. The facility is approved for (4) hospice residents. Currently, the facility has (1) resident in hospice care. Facility fees are current, liability insurance active (00146539-2 Exp: 08/03/26).

The facility is a single-story structure located in a residential neighborhood. It consists of the following: (5) resident's rooms, (2) common bathrooms, (1) staff bedroom, (1) staff bathroom, an open space that consist of a living area, a dining area, and kitchen area. There is an outside covered patio area, and an attached garage. There were no weapons, bodies of water or obstructions on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for resident personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. Bathrooms were found to be within Title 22 regulations and were clean and operational. The water temperature measured between 105 F-120 F. Cleaning supplies, toxins, and sharps were stored and not accessible to residents. LPA observed there is sufficient perishable and non-perishable food available. Fire extinguisher was charged, smoke detectors and carbon monoxide were operable. The last fire was conducted on 07/01/25. A land line was observed.

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.

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