Facility Evaluation Report

Licensing Program Analysts (LPA) Jose Tan conducted an Annual Required visit and inspection of this facility today and met with Administrator Paola Tapia and explained the reason for the visit. At approximately 9:34 AM, a tour of the physical plant was done with the Administrator.

Infection Control: There is only one entrance being utilized at the facility, the front main entrance door. The two (2) side doors are for emergency only. Screening area is located immediately upon entrance in the reception area. All visitors/resident and staff are required to sign. There is also a sign in sheet, hand sanitizer, gloves and masks available. The facility had submitted and approved Mitigation plan. The facility have multiple designated visitors' area in the front entrance. The facility has sufficient stock of PPE in the storage room.

The facility is fire cleared for fourteen (14) ambulatory and two (2) non-ambulatory residents. This is a short term crisis residential facility. There are fire extinguishers all over the facility and last inspected on 05/29/25. The facility is equipped with sprinkler system. The facility temperatures was set at 72.0°F. The smoke alarm are hard wired and interconnected and last tested on 5/27/25. Fire and sprinkler inspection equipment test was done on 12/06/24 valid for five (5) years. There is a carbon monoxide installed in the facility. Fire drill was last done on 08/31/25.

Kitchen: The facility has a food waiver and food is being catered. The kitchen is only being utilized for heating food and emergency food storage. The kitchen appeared clean and the appliances and fixtures functional. (continued on LIC 809-C)