Facility Evaluation Report

Licensing Program Analysts (LPAs) Blanca Gonzalez and Mayra Cota conducted an unannounced Case Management-other (CM). LPAs met with Maritza Cruz, Caregiver, and the reason for the visit was explained. Administrator Linda Morales was notified telephonically and arrived at a later time. Manager Stacy Santana Lopez arrived to facilitate today’s visit.

During today’s visit LPAs obtained staff and resident rosters, toured the facility, conducted interviews with staff #1-3 (S1-S3) and reviewed resident records #1-6 (R1-R6).

Today’s CM visit stems from an annual inspection visit conducted on 10/06/25. During the annual visit, LPA Gonzalez observed facility to have five (5) resident bedrooms, however the facility sketch indicates that bedroom #4 is one (1) shared bedroom. During today’s visit LPAs observed bedroom #4 has two (2) twin beds, beds appear to be in different rooms as they are separated by a hallway.

Per interview with S1 and S2, bedroom #4 is one (1) shared bedroom. Licensee agreed to move forward with Fire Inspection request. Licensee will submit to the department LIC200 and updated facility sketch within the next week. Once licensee submits relevant documents, Fire Inspection request STD850 will be submitted by the department.