Facility Evaluation Report

On September 24, 2025, at 9:15 AM, Licensing Program Analyst (LPA) Edward Kim conducted an unannounced required 1-Year annual visit using the CARE Inspection Tool. Upon arrival at the facility, LPA Kim met with Administrator (ADMIN) Jeremias Filio and explained the purpose of the visit.

The facility is licensed to operate for five (5) nonambulatory residents of which one (1) may be bedridden and have a hospice waiver for six (6) residents. The facility is a single-story building located in a residential neighborhood. It consists of the following: six (6) resident bedrooms, one (1) staff bedroom, four (4) bathrooms, living area, dining area, kitchen, outdoor patio area, and an attached two car garage.

LPA Kim toured inside and outside of the physical plant. There were no bodies of water or obstructions on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for each resident’s personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. The Resident’s rooms were inspected: Resident Room 1, Resident Room 2, Resident Room 3, Resident Room 4, Resident Room 5, and Resident Room 6. Bathrooms were found to be within Title 22 regulations and were clean and operational. The water temperature measure 113.9 degrees F to 116.0 degrees F. A comfortable temperature of 79 degrees F was maintained in the facility.