Facility Evaluation Report

Licensing Program Analyst (LPA) Jessica Cho arrived at the facility unannounced for the purpose of conducting the Required 1-Year annual evaluation using the CARE Inspection Tool. LPA was greeted and granted entry by Caregiver Joselito Gamas after introducing self and stating the reason for the visit. Administrator Arlene Fajardo arrived on premise to assist with the inspection. Administrator Fajardo has a valid certificate expiring June 18, 2027 per the Active Administrator Certificate List.

The following was observed during the inspection: The facility is located in a residential neighborhood comprised of two private resident bedrooms, two shared resident bedrooms, two resident full bathrooms, and a shared staff bedroom. LPA observed six residents in care, three of which are on hospice. LPA observed two staff on duty. Facility is operating within the conditions and limitations specified on the license.

LPA toured the physical plant. LPA inspected all common areas including the attached two car garage and all bedrooms. The resident bedrooms' were appropriately furnished, beds and bedding supplies were in good condition, adequate lighting was provided, and sufficient storage space for each residents' personal belongings were observed. Facility appeared clean, sanitary, and in good repair as well as all bathrooms. . Slip resistant mats were observed to be available in the bathrooms. The hot water temperature in the resident bathrooms measured within range at 112.2 and 116.4 degrees Fahrenheit. Toxins, disinfectants, sharps, and medications were secured and inaccessible. LPA observed ample two-day supply of perishables and seven-day supply of non-perishable food.

LPA toured the exterior portion of the facility. The outdoor passageway is free of obstruction, and there are sufficient seating and shading. LPA observed two secured gate exits that were operable.