Facility Evaluation Report

On 12/04/25 Licensing Program Analyst (LPA) Mario Leon conducted an unannounced annual visit. LPA was met by staff one, Bernard Basilan (S1) and the purpose of the visit was explained.

The facility is licensed to serve four (4) residents of which three (3) may be non-ambulatory. The facility is a single-story home in a residential neighborhood. It consists of four (4) resident rooms, kitchen, dining room, living room/office area and a shaded outdoor sitting area. All walkways around the home were observed clean, clear, and free of debris/obstructions. The indoor temperature was at a comfortable 72.9 degrees Fahrenheit (°F) and the fences open from the backyard to exit.

LPA inspected the four (4) resident bedrooms and found them to be clean and in good repair. The department observed the bedrooms have the required furniture including a bed, dresser, nightstand with a lamp, chairs, and ample storage space for residents’ personal belongings. The department observed the beds have the required linens including a mattress cover, fitted sheets, blanket, comforter, and pillows. The department observed an ample supply of linens in a cabinet in the hallway, in good repair.

LPA inspected two (2) bathrooms in the facility. All bathrooms were found to meet Title 22 regulations. All bathrooms were observed operable. The showers were observed clean, and clear of mold or mildew. The showers had secured safety handrails, nonskid mats, and shower chairs. The water temperature measured within title 22 regulation. LPA observed an ample supply of towels in a cabinet in the hallway and an additional supply stored in residents’ closets, as well as ample linens.

LPA inspected the kitchen and found it to be clean and sanitary. All appliances were observed to be in good repair and are operable. The department observed an ample supply of cook ware, dishware, and cutleries. The department observed a 3-day supply of perishable foods and a 7-day supply of non-perishable foods properly packaged and stored. Additionally, LPA observed an emergency supply of non-perishable food, stored above resident files. Report continues, please see LIC809C.