Facility Evaluation Report

On July 29, 2026, Licensing Program Analysts (LPAs) Brandon Lopez and Tran Nguyen made an unannounced visit to the facility to conduct a Case Management - Health Checks. LPAs were greeted and granted entry into the facility by staff after explaining the purpose for the visit. Licensees Allen Medina &

Maricel Nepomuceno were notified via telephone but were unable to assist with today's inspection.

On today's visit, there are five residents in care and there were two care giving staff present. LPAs, accompanied by a care giving staff, conducted a tour of the physical plant. LPAs inspected the six resident bedrooms and observed them to be free of hazards. LPAs observed the lights in each of the resident's bedroom to be operational. LPAs observed residents bedrooms to have the required furnishings of a bed, a chair, a chest of drawers, and a lamp. LPAs observed resident beds to have clean linens and blankets. LPAs inspected the four bathrooms located in the facility. LPAs observed bathrooms to be clean. Bathrooms are equipped with grab bars and non-skid floor mats. Hot water temperature measured between 109.9 and 111.7 degrees Fahrenheit.

LPAs inspected the facility's kitchen area and observed it to be clean. LPAs observed the facility has a two day perishable and seven day nonperishable food supply on hand. LPAs observed the facility has a three day emergency food and water supply stored in the pantry. LPAs, accompanied by a care giving, conducted a tour of the exterior portions of the facility. LPAs observed the exterior to be free of any hazards or obstructions. No health or safety concerns were observed during the visit. LPAs observed all of the facilities utilities to be operational during the visit. LPAs additionally conducted interviews with two staff during the visit. CONTINUED ON LIC809-C