Facility Evaluation Report

Licensing Program Analyst (LPA) Antonia Alvizar-Ettima conducted an annual required visit and inspection of the facility. LPA met with Caregiver and gained entry. The reason for this visit was explained. Caregiver contacted Administrator via telephone and joined the visit.

At approximately 1:45p.m., LPA and Administrator conducted a physical plant tour. LPA observed required postings such as Long-Term Care Ombudsman, Emergency Disaster Plan, and Personal Rights located alongside the entrance hallway leading towards the kitchen. The facility is a single-story building with three (3) bedrooms and two (2) bathrooms currently occupying six (6) residents. The facility has an approved fire clearance for six (6) non-ambulatory residents of which one (1) may be bedridden. Dual Smoke and Carbon Monoxide detectors were tested and function properly. They are in each bedroom and hallway. Facility Emergency Fire/Earthquake Drills were conducted on 03/02/2026. The fire extinguisher is in the dining room with purchase date of 02/14/2026.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following:

Common areas: The living room and dining room were observed to be neat, clean, and organized. The rooms were observed to be properly furnished and in good repair. The facility maintains a comfortable temperature at 74°F. A fireplace was observed to be covered and inaccessible to residents. A working telephone was observed. Kitchen: The kitchen appliances and fixtures were functional. The kitchen has a working gas stove, faucet, freezer, refrigerator, and microwave. LPA found at least two (2) days perishable and seven (7) days non-perishable food at the facility that is properly stored. Frozen foods are wrapped,