Facility Evaluation Report

Licensing Program Analyst (LPA) Bennette Pena conducted an unannounced required- 1 year visit. LPA met with Patricia Wong, Wellness Coordinator and explained the purpose of the visit. Shortly after, administrator, Hector Vargas arrived and and assisted LPA. The facility is approved to serve residents age range 60 and over, approved for capacity of (40) residents of which (30) ambulatory and (10) non ambulatory; approved hospice waiver for (5) hospice residents. The facility provides care and support services primarily tailored for blind and visually impaired adults. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following:

Infection Control: Infection control practices and Personal Protective Equipment (PPEs) were maintained. Staff are trained on the emergency infection control plan and following hand hygiene techniques. Emergency Infection Control Plan was reviewed and updated on 01/26/2026.

Operational Requirements: Facility does not accept nor retain residents with dementia. Plan of Operation was reviewed and the Infection Control Plan has been added to the Plan. Liability Insurance in the amount of at least ($1,000,000) per occurrence and ($3,0 00,000) in total annual aggregate is in place and expires 07/15/2027. Fire drill was last conducted on 07/15/2026.

Physical Plant/Environment Safety: The facility is a single story building located in a commercial area. The facility consists of (2) separate buildings: 1st building (single story) consists of (20) resident rooms and (14) bathrooms, (5) community shower room, laundry room, outside patio, medication room, living room/receiving area, dining area, kitchen and pantry. 2nd building in the back (2 story): 1st floor consists of administrative office, conference room, storage room, detached garage. 2nd floor consists of accounting office and medical office. The interior and exterior physical plant was inspected. Exit doors are free of any obstruction and there are no pools or large bodies of water. The facility is equipped with cameras in the common areas. The bathrooms were observed to be clean and operational. Cleaning supplies and toxic substances are inaccessible to residents. Water temperature readings measured within the required 105 - 120 degrees Fahrenheit, bathroom #1 (107.1 deg F) and bathroom #2 (112.8 deg F). The kitchen was observed to have sufficient amount of perishable and non-perishable food supplies. LPA observed perishable food was stored in covered containers at the appropriate temperatures. There are cameras without audio in the common areas. Fire extinguishers were observed throughout the facility and were last serviced on 04/21/2026. Smoke detectors, fire sprinklers and pull fire alarm system observed and hard wired to the City of Sierra Madre Fire Department. *****CONTINUED ON LIC809-C*****