Facility Evaluation Report

On June 16, 2026, 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. Administrator Teresita Lozano was contacted and notified about inspection visit. Caregiver Mary Jane Tan was available to assist with the facility inspection. Administrator Teresita Lozano arrived during middle of inspection tour and was able to finish assisting with visit.

The facility is licensed for six (6) non-ambulatory residents with approved hospice waiver for two (2) residents. Currently, there is zero (0) residents on Hospice during today’s visit.

This is a single story home with a detached garage facility. The facility has Six bedrooms (five private resident rooms and one staff room), dining room, living room, activity den, kitchen and four bathrooms.

LPA conducted a tour of the physical plant accompanied by caregivers and the following was observed: Facility has a swimming pool with secured fence 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 and bath towels were available during the visit. Bathrooms were operational with water temperature measured between 105.2 to 111.5 degrees F. A comfortable temperature of 77 degrees F. was maintained in the facility.

LPA observed the facility to be furnished at the time of the visit. Storage areas for cleaning chemicals and sharps objects was observed. The kitchen was inspected, and sufficient two day perishable and Seven day non-perishable food was maintained adequately. CONTINUED ON 809C