Facility Evaluation Report

On 12/11/25, Licensing Program Analyst (LPA) Villegas conducted an unannounced annual required visit with a primary focus on Infection Control measures using the new CARE Inspection Tool. LPA met with Archie Reyes and explained the purpose of today’s visit. The facility is licensed to operate for(6) non-ambulatory elderly residents ages 60 and above. The facility is approved for (2) hospice residents, there is currently (1) resident receiving hospice services. Facility fees are current, liability insurance is active (exp: 03/10/2026).

The facility is a single-story structure located in a residential neighborhood. It consists of the following: (5) resident's rooms, (2) common bathrooms, living area, dining area, kitchen, a staff room, and outside covered patio area. There were no 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 clean and operational. The water temperature measured 105 F.- 120F.. LPA observed the facility to be sanitary and appropriately furnished at the time of visit. Storage areas for personal hygiene were stored and not accessible to residents. The kitchen was inspected and there is sufficient perishable and non-perishable food available and maintained properly. A working land line was observed.

LPA conducted a review of 5 residents files, 5 medication records, and 3 staff files. Medications were centrally stored and properly locked, first aid kit was checked and fully stocked. The last drill was conducted on 08/06/25, 2 fire extinguisher fully charged, carbon monoxide and smoke detectors are operational.

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