Facility Evaluation Report

Licensing Program Analysts (LPA) Jose Tan conducted an Annual Required visit and inspection of this facility today and met with Administrator Shannon Morales and explained the reason for the visit. At approximately 10:05 AM, a tour of the physical plant was done with the Administrator.

The facility is fire cleared for fourteen (14) ambulatory and two (2) non-ambulatory residents on Room #3 and #4. The facility uses surveillance cameras in the common areas inside. This is a short term crisis residential facility. There are fire extinguishers all over the facility and last inspected on 05/13/25. The facility is equipped with sprinkler system. The facility temperatures was set at 74.0°F. The smoke alarm are hard wired and interconnected and last tested on 09/15/25. 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 07/15/25.

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 and Infection Control Plan. The facility have a designated visitors' area in the front entrance.

Kitchen: The facility has emergency water supplies and emergency food supplies in the first-floor pantry. The pantry contained sufficient supplies of non-perishable only food at this time. The pantry also contained refrigerators, freezers, cooking tops and a retherm unit. (continued on LIC 809-C)