Facility Evaluation Report

On June 4, 2025 at 1:15 PM 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 was greeted and granted entry by Caregiver (CG) Orlando Delos Angeles. Licensee (LI) Concordia Velasco was contacted over the phone and LPA explained the purpose of the visit. LI Velasco arrived around 1:50 PM and left around 3:20PM. LI Velasco stated that CG Delos Angeles could sign in behalf of the facility.

The facility is licensed to operate for four (4) non-ambulatory and have a hospice waiver for two (2) residents. The facility is a single-story structure located in a residential neighborhood. It consists of the following: Three (3) resident bedrooms, one (1) staff bedroom, two (2) bathrooms, living area, dining area, kitchen, and an outside covered patio area.

LPA Kim toured indoor and outdoor of the physical plant with LI Velasco. There are 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. All bedrooms were inspected: Resident Room 1, Resident Room 2, Resident Room 3, and Staff Room 1. Bathrooms were found to be within Title 22 regulations and were clean and operational. The water temperature measured at 109.7 and 109.9 degrees F. A comfortable temperature of 76 degrees F was maintained in the facility.