Facility Evaluation Report

Licensing Program Analyst (LPA) Hanna Gough made an unannounced visit to the facility to conduct the required annual inspection. Upon arrival tenant Mylene Baldazo answered the door and greeted LPA. Mylene informed LPA that there is no longer a facility at the residence and that they rent the home with their family. LPA was granted entry to confirm no care was being provided. Mylene called Administrator/Licensee (AD) Teresita Damicog and confirmed that the facility is closed and that they would like to forfeit their license as they have retired.

LPA toured the facility and observed no care being provided with the last resident moving out on February 11, 2026.

An exit interview was conducted and a copy of this report was left at the facility.