Facility Evaluation Report

On 10/10/25 at around 9:20AM, Licensing Program Analyst (LPA) Mario Leon conducted an unannounced Required – 1 Year Inspection at the facility and met by staff one, Ceceni Rose - Administrator (S1) and the purpose of the visit was explained.

The facility is a one-story house located in a residential area. The home consists of four (4) resident bedrooms, one (1) staff bedroom, three (3) bathrooms, a kitchen and a dining/living room area, with a backyard patio with shaded seating; including a fully gated swimming pool. The facility currently hosts five (5) residents; including four (4) residents receiving hospice care, although this facilities' license allows for one (1) resident receiving hospice. One technical violation has been cited, please see LIC9102TV.

LPA toured the facility, inside and out, with staff two, Maricar "Lea" Avendano (S2). LPA observed, and questioned, no security bars or weapons on the premises. LPA toured the kitchen area and observed supplies of 7 days of nonperishable foods and 2 days perishable food for residents in care. Knives and toxins were kept in locked storage cabinet, inaccessible to residents in care and all heating sources are secured and screened.

LPA observed that medications were secured and inaccessible to residents in care. All medications observed were labeled and maintained in compliance with label instructions and State and Federal law. Documents are posted as mandated, located behind the fireplace island . First aid kit is fully stocked, along with manual. Smoke and carbon monoxide detectors were in compliance and operational. There is a fire extinguisher in the kitchen, last serviced on 09/08/2025 . Four (4) out of 5 bedrooms were checked. Mattresses were in good condition, adequate lighting, plenty of dresser and closet space observed. Walls and floors were clean and in good condition. LPA observed cobwebs in bedroom one's (BR1) lamp. LPA observed two light switches needing minor repair, yet are still in working order. Comforters, bed linen, bath towels and mattress protectors were adequately stocked. Bathroom toilets and water faucets worked properly, grab bars were secure, and non-skid mats were in place. Adequate lighting and toiletries are accessible to residents in care.

The report continues, please see LIC809C.