Facility Evaluation Report

Licensing Program Analyst (LPA) Sam Haddadin conducted an unannounced required annual inspection using the CARE Inspection Tool. Upon arrival at the facility, LPA Haddadin was greeted and granted entry by Caregiver (CG) Connie Martinez.

The facility is licensed to serve six (6) non-ambulatory residents, of which one (1) may be bedridden. The facility also has a hospice waiver for three (3) residents. The facility is a single-story structure located in a residential neighborhood and consists of five (5) resident bedrooms, one (1) staff bedroom, three (3) bathrooms, a living area, dining area, kitchen, attached garage, and an outdoor covered patio area. At the time of the visit, there were five (5) residents in care.

During the inspection, LPA toured the interior and exterior areas of the facility. All bathrooms were observed to be clean, sanitary, and operational. Hot water was tested and measured between 103.9 degrees Fahrenheit and 104.2 degrees Fahrenheit and a deficiency was cited for the hot water. The kitchen was observed to be clean and organized, with an adequate food supply, including at least a two-day supply of perishable food and a seven-day supply of non-perishable food. Knives and cleaning supplies were secured in a locked kitchen cabinet and were inaccessible to residents. All kitchen appliances were observed to be operational and in working condition.

The fire extinguishers were observed to be fully charged, with the most recent purchase date recorded as May 20, 2026. Smoke detectors and carbon monoxide detectors were tested and found to be operational. The first aid kit contained the required supplies. Medication was observed to be locked and secured in a cabinet located in the hallway.