Facility Evaluation Report

On 12/19/2025 at 8:30am, Licensing Program Analyst (LPA) Wendy Gibbs, conducted an unannounced Annual Visit to the facility listed above. LPA met with Evangeline Agatep, Administrator, and the purpose of today’s visit was explained. LPA was granted entry into the facility. The facility is licensed to serve six (6) non-ambulatory residents of which one (1) may be bedridden. The facility has an approved hospice waiver for two (2) residents.

Physical Plant/Structure The facility is a single-story structure in a residential neighborhood. It consists of the following: five (5) resident bedrooms, two (2) bathrooms, one (1) staff, sitting room, living room, kitchen, dining area, laundry area, two (2) outdoor shaded patio areas, and attached garage. LPA observed tables and chairs in the outside seating areas. LPA observed all walkways around the outside of the facility were observed clean, clear, and free of debris, obstructions, and hazards. LPA did not observe any bodies of water on the premises.

Bedrooms LPA inspected all residents’ bedrooms and observed them to be clean and in good repair. LPA observed bedrooms have the required furniture including a bed(s), dresser(s), nightstand(s), chair(s) and ample storage space for residents’ personal belongings. LPA observed beds have the required linens including a mattress cover, fitted sheets, blanket, comforter, and pillows. LPA observed an ample supply of bed linens in good repair.

Bathrooms LPA inspected residents’ bathrooms and staff bathroom and observed them to be within Title 22 Regulations. LPA observed the toilet, faucets and showers working properly. LPA observed secured safety handrails and non-skid material in the shower. LPA observed the showers to be clean