Facility Evaluation Report

On 12/04/25 Licensing Program Analyst (LPA) Villegas conducted an unannounced required annual visit using the CARE Inspection Tools. LPA met with staff Ruby Vidad as the purpose of the visit was explained. The facility is licensed for (6) 60-year-old or older non-ambulatory adult residents; 2 may be bedridden in bedroom #2. There is an approved hospice waiver for 6. Facility fees are current, liability insurance active (09/24/26).

The facility is a one story home that consists of (4) resident bedrooms, (3) resident bathrooms, living room, dining room, kitchen, pantry room, office area, attached garage with washer and dryer/ storage area, and a backyard with table and chairs. 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. LPA observed that facility had required postings . 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 4 staff records, 3 client records, and 3 medication administration records. Medications were centrally stored and properly locked, first aid kit was checked and fully stocked. The last fire was conducted on 09/12/25, 1 fire extinguisher fully charged, carbon monoxide and smoke detectors are interconnected and operational.

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