Facility Evaluation Report

Licensing Program Analyst (LPA) Rose Ruppert made an unannounced visit to conduct an Annual Required Evaluation. LPA was greeted and granted entry by Staff #1 (S1) at 8am LPA met with House Manager Miriam Esquivel and explained the purpose of the visit.

The facility is a four bedroom, three bathroom single story residence in which one bedroom and one bathroom is used by live-in staff. The facility has an approved fire clearance of four ambulatory; of which two are approved for hospice. The facility currently has a census of four residents in care and none receive hospice services.

During the visit LPA toured the kitchen and all appliances were in working order. The refrigerator had two-days of perishable items and seven-days of non-perishable food on-hand. Emergency water and supplies were observed in the garage with the washer and dryer. Sharps and knives were secured in a locked toolbox and cleaning supplies were stored in a locked storage closet. The facility was clean and there were no odors detected.

LPA observed resident rooms had all of the required furnishings and were clean. LPA measured the hot water temperature in two of two resident bathrooms and hot water measured between 107.0-108.5 degrees Fahrenheit. All bathrooms had non-skid mats and grab bars. The smoke and carbon monoxide detectors were inspected and detectors were operational. The fire extinguisher was charged and inspected on April 1, 2026. The facility's last fire drill was documented on March 12, 2026 on the fire log. LPA requested the Emergency Disaster Plan which was not posted. A Technical Violation will be given for LIC 610E to be posted and updated.