Facility Evaluation Report

On 04/17/26, Licensing Program Analyst (LPA) Villegas conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with Arturo Yangco as the purpose of the visit was explained. The facility is licensed to serve (6) non ambulatory residents 60 and above, there is an approved hospice waiver approved for (4). Liability Insurance is active (exp: on 4/29/2026), facility fees are due (Balance: $495, due date: 4/20/26 Pin: 105407).

The facility is a single-story structure located in a residential neighborhood and consists of the following: (6) bedroom of which (4) are resident bedrooms, and (2) are staff bedrooms, (1) resident bathroom, (1) staff bathroom, a living room, dining room, kitchen, an attached garage with washer and dryer/ storage area, and a backyard with table and chairs . Please note that the staff have there own separate kitchen and living room. All resident bedrooms were checked, mattresses and box springs were in good condition, adequate lighting, plenty of dresser and closet space was observed. Bathroom toilets and water faucets worked properly, shower was free of mold/mildew, and there are sufficient toiletries accessible to residents. The water temperature properly measured between 105-120 F.. A supply of perishable and non-perishable food was observed, toxins and knifes were stored and inaccessible to residents, no weapons nor bodies of water on the premises, exits and walkways are free of debris/hazards.

LPA conducted a records review of 3 staff records, 3 client records, and 3 medication administration records, Medications were centrally stored and properly locked. A first aid kit was checked and fully stocked, 2 fire extinguishers fully charged, carbon monoxide and smoke detectors are interconnected and operational.

Deficiencies cited on 809 D. Exit interview conducted, appeal rights explained, and a copy of this report was provided.