Facility Evaluation Report

Licensing Program Analyst (LPA) N. Galarza arrived at the facility unannounced for the purpose of conducting the Required 1-Year annual evaluation. LPA was greeted and granted entry by caregiver Helia De La Cruz. Administrator Bessie Coello arrived shortly after. Administrator's certificate expires 1/4/2027.

The following was observed during the inspection:

Infection Control: The facility has an Infection Control Plan.

Operational Requirements: The Residential Care for The Elderly (RCFE) facility has Dementia and hospice waiver for 5 residents. A fire clearance for 5 non-ambulatory and one (1) bedridden resident in room #4. Facility does not handle resident P & I monies. Liability Insurance in the amount of at least ($1,000,000) per occurrence and ($3,000,000) in total annual aggregate is current with an expiration date of 11/3/2026.

Physical Plant/Environment Safety: The interior and exterior physical plant was inspected. The facility is a single-story home located in a residential area consisting of four (4) bedrooms, 2 of which are shared, 2 bathrooms w/grab bars, kitchen, dining room, living room, laundry room/medication room, backyard, and office. Resident rooms are equipped with required furniture, lighting, bed linens, mattress pads, closet/drawer space to accommodate each resident comfortably. Cleaning supplies and toxic substances are inaccessible to residents. The facility has one fire extinguisher. Water temperature readings measured within the required 105 - 120 degrees Fahrenheit. Electrical smoke and carbon monoxide detectors were tested and are operational. The facility maintains emergency food supply and water. Emergency Phone numbers, exit plan and programming schedules are posted. The facility is equipped with central air conditioning and heating. Exit doors are free of any obstruction and there are no pools. There are outdoor and indoor surveillance cameras. Medication “Diclofenac Sodium Topical Gel” was observed unlocked. Room #3 has 2 oxygen tanks, but no "No Smoking-Oxygen in Use ". The last Emergency Disaster drill was conducted on 7/1/2026.