Facility Evaluation Report

On this day Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. made an unannounced Plan of Correction (POC) visit in conjunction with the Case Management and citations issued on March 14, 2025. LPA was greeted and granted entry into the facility by Caregiver Leonard Noble. LPA explained the reason for the visit. Administrator (AD) Olivia Hidayat was notified via telephone by staff.

During today's visit, LPA also conducted a Health and Safety inspection. AD Hidayat has a current Administrator Certificate with the expiration date of September 6, 2026. During today's visit, LPA also conduced a Health and Safety visit. LPA and Noble conducted a toured of the facility and observed the facility has electricity, water, and gas. Water temperature tested between 115.4 and 118.0 degrees Fahrenheit. Client bedrooms were observed to have the required furnishings. Certificate of liability insurance was observed to be posted and current. The kitchen was observed to be clean and organized and a 2-day supply of perishable and a 7-day supply of non-perishable food was observed. Medications are kept locked in a closet and knives are kept locked in a kitchen drawer. All and any toxic chemicals, cleaning solutions, laundry toxins, and disinfectants were observed to be inaccessible to clients. Fire extinguisher was observed to be fully charged with a service tag dated March 12, 2025. Gas stove, microwave, washer, and dryer were all inspected and observed to be operable.

As of 03/26/2025, Deficiency cited under Title 22 Regulation 80066(f) pertaining to Personnel Records (In all cases, personnel records shall document the hours actually worked) has been CLEARED.

As of 03/26/2025, Deficiency cited under Title 22 Regulation 80012(a) pertaining to False Claims has been CLEARED.