Facility Evaluation Report

On 10/13/2025, Licensing Program Analyst (LPA) Perchui Milena Khurshudyan arrived at this facility to conduct a required Annual Inspection. Upon arrival LPA was greeted by the Medical Assistant/Caregiver Melissa Salcido Delgado, who granted access to the facility. LPA showed her badge and explained the reason for the visit. The facility CNA/Residence Manager Rafael Lopez arrived shortly after and helped with staff/residents’ files. Entrance interview conducted. LPA Khurshudyan reviewed the required postings on a wall throughout the facility. The inspection tool was used to complete today's visit.

At 10:55am LPA, with the help of the Medical Assistant, began a physical plant tour of the facility and the following was observed: This is a single-story building with four (4) bedrooms, two (2) bathrooms, kitchen, garage, common areas, and outdoor areas. It has an approved fire clearance for six (6) clients. Facility is operating – as Residential Facility for Chronically Ill.

Kitchen: LPA observed a seven-day supply of non-perishable food, and a two-day supply of perishable food properly stored and labeled. No expired food was observed. Facility stores knives and sharps inside the locked closet located in the hallway next to the entrance door. Emergency supply of food / water was stored inside the pantry located in the garage. Food storage and preparation areas are clean and inaccessible to pests. LPA observed two (2) fire extinguishers with a last service dated 2/27/2025. A weekly menu was also available for clients and was posted on the fridge.

Bedrooms: There are four (4) bedrooms in the facility, all bedrooms are designated for clients’ use only. LPA observed bedrooms to be properly furnished with beds, linens, nightstands, chairs, drawers, closets, and adequate lighting. All bedrooms appeared organized and clean.