Facility Evaluation Report

Licensing Program Analyst (LPA) Galarza conducted an unannounced annual inspection visit. The purpose of the visit was explained to Assistant Administrator Mauricio Santos. The facility serves elderly residents ages 60 and older.

Infection Control: The Infection Control Plan was reviewed and includes environmental cleaning and disinfection activities. Facility has sufficient Personal Protective Equipment.

Operational Requirements: A Dementia and hospice waiver for 4 residents has been approved. A fire clearance for 3 non-ambulatory and 3 bedridden resident. Facility does not handle resident P & I monies. Liability Insurance in the amount of at least ($1,000,000) per occurrence and ($3,000,000) in total annual aggregate is current with an expiration date of 10/6/2025.

Physical Plant/Environment Safety: The facility is a single story home located in a residential neighborhood. The facility is owner operated and consists of 5 bedrooms; 4 for residents [3 private & 1 shared) and 1 staff bedroom for licensee, 3 bathrooms, living room, dining room, kitchen, outdoor covered patio area, laundry room, and a 3 car detached garage in the rear of the property presently being used as storage area. Smoke and carbon monoxide detectors were tested and are operational. The facility has one (1) fire extinguisher. Water temperature readings measured within the required 105 - 120 degrees Fahrenheit. The facility has a 1st Aid Kit and Manual. Cleaning supplies, knives, and toxic substances are inaccessible to residents. The last Emergency Disaster drill was conducted on 3/9/2025. Exit doors are free of any obstruction and there are no pools or large bodies of water.

Staffing: A total 4 staff members provide care and supervision to the clients.