Facility Evaluation Report

Licensing Program Analyst (LPA) Hanna Gough arrived at the facility to conduct the required annual inspection. LPA was greeted and granted entry by staff. LPA met with Licensee/Administrator (AD) Liza Dela Cruz and discussed the purpose of the visit. The facility currently has five residents in care.

The facility is a one story home with seven bedrooms, two bathrooms, living room, kitchen, dining room and attached two car garage. The facility appears clean, safe and sanitary. LPA observed the required departmental postings throughout the facility. LPA observed the resident bedrooms to have the required components and furnishings. LPA observed a clean supply of extra linens in the hall closet by the front bathroom. LPA observed the bathroom to have toilet paper, paper towels and nonslip mats in the shower. LPA tested the water temperature to be at 113.5 degrees Fahrenheit. LPA observed the kitchen to be clean and free of vermin. LPA observed a two day perishable and seven day nonperishable food supply on hand. LPA observed the knives to be locked under the kitchen sink and made inaccessible to residents in care. LPA observed a fire extinguisher in the kitchen charged and with a service date of August 29, 2025. LPA observed the garage to have extra food storage. LPA observed a locked cabinet in the garage to store the toxins and chemicals and made inaccessible to residents in care. LPA observed the backyard to have a shaded seating area for resident use. LPA observed the backyard to be free of debris and obstructions. LPA and AD tested the fire alarm and smoke detectors and they were found to be operational.

LPA reviewed staff files and one of two staff do not have updated 20 hours of annual training on file. LPA observed resident files and one of five residents to have an outdated appraisal. LPA reviewed resident medication and no discrepancies were observed. LPA observed the last fire drill to be conducted on August 20, 2025.