Facility Evaluation Report

On September 25, 2025, Licensing Program Analyst (LPA) Jenifer Tirre conducted an unannounced required visit using the CARE Inspection Tool. LPA was greeted by staff and granted entry after stating the purpose of the visit. Staff contacted Administrator/licensee Osvaldo Santa ana, LPA talked to Administrator/ Licensee Santa Ana via telephone, who informed LPA they are unable to come down to facility and have assigned Staff member Anita De Ala to assist with inspection visit.

The facility is licensed for six (6) non-ambulatory residents with approved hospice waiver for six (6) residents. Currently, there are three (3) Hospice residents present during today’s visit.

This is a single story with attached garage facility. The facility has five bedrooms (2 private resident rooms, 2 shared resident rooms and 1 staff room). Facility has two (2) bathrooms.

At around 1:15PM, LPA conducted a tour of the physical plant accompanied by staff member Anita De Ala and the following was observed: There were no bodies of water on the premises. All rooms were inspected. Beds and bedding supplies were in operational condition, lighting was provided, and storage for the client's personal belongings was observed. Bed linens, comforters, and bath towels were available. Bathrooms were operational with water temperature measured between 105.8 to 111.3 degrees F. A comfortable temperature of 78 degrees F. was maintained in the facility.

LPA observed the facility to be furnished at the time of the visit. Storage areas for sharps objects, and cleaning supplies were secured and not accessible to residents. The kitchen was inspected, and sufficient two day perishables and Seven day non-perishable foods were maintained. CONT ON 809