Facility Evaluation Report

On today's date Licensing Program Analyst (LPA) William Vanegas conducted an unannounced visit for the purposes of conducting an annual inspection. Upon arrival LPA was greeted and granted entry to the facility by facility staff. LPA explained the purpose for the visit, and Administrator (AD) Noel VIllegas was notified via telephone and arrived shortly after to assist with annual inspection. LPA began a tour of the facility and observed the following. AD has a valid Administrator certificate valid from June 14 2026 through June 13, 2028.

The facility is a one storied home that is equipped with seven bedrooms one of which is a staff room and six of which are utilized for residents in care. The facility is equipped with two and a half bathrooms, and a detached two car garage. LPA observed kitchen area to be clean and free of any mildew and debris. LPA observed the kitchen area to have a gas stove, refrigerator, and a microwave. All appeared to be in good repair and tested operational. LPA observed for there to be a two day supply of perishable food and a seven day supply of non-perishable food. Additionally a sufficient amount of emergency water was noted to be on hand.

LPA observed all resident bedrooms to be free of any obstructions and any hazards. LPA observed bedrooms to be large enough to walk about freely, and for them to have all required furnishings including a chest of drawers, a bed, clean linens in good repair; meaning no strains or tears, a chair, a reading lamp, and enough storage space to tore personal belongings. LPA observed all restrooms to be clean and free of any mildew and debris. LPA observed restrooms to have all required furnishings such as grab bars, a shower chair, and slip resistant floor matts. Hot water temperature tested between and degrees Fahrenheit. CONTINUED ON LIC809-C