Facility Evaluation Report

Licensing Program Analyst (LPA) Kimberly Ramirez conducted an unannounced subsequent annual inspection visit on 9/26/2025 and was greeted by Assistant Administrator Gloria Gibson. LPA Ramirez identified herself and explained the purpose of the visit. Administrator Brian Buenviaje arrived shortly after to assist. On 09/04/2025, LPA Ramirez conducted an initial unannounced annual inspection visit, due to time constraints a subsequent visit would be required to complete the annual inspection. The facility is located on a residential street and is a single store dwelling.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following:

Staffing: Administrator Certificate for Brian Buenviaje 09/27/2025 was observed. Staff employed are over the age of 18 and are fingerprint cleared and associated to the facility.

Personnel Records Training: Staff files are maintained at the facility. LPA Ramirez observed CPR and First Aid for four (4) out of the four (4) personnel record reviewed. LPA Ramirez observed TB testing results, Health screening, fingerprint clearance and job application for four (4) out of the four (4) personnel record reviewed. Two (2) out of the two (2) caregiver personnel records reviewed did not have documentation of the required 20 hours of annual training; 8 hours specific to dementia, and four hours specific to postural supports, restricted health conditions, and hospice care. LPA Ramirez will issue a Type B deficiency based on this record review.

One (1) deficiency was issued. A copy of this report, 809-D and appeals rights was provided.