Facility Evaluation Report

On July 6, 2026, at 9:00 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 Operations Manager (OPMAN) Irene Infante and explained the purpose of the visit

The facility is licensed to have a capacity of six (6) nonambulatory residents, of which one may be bedridden, and a hospice waiver for five(5) residents. LPA Kim observed the following. The facility is a one-story house with five (5) resident bedrooms, three bathrooms, dining room, a kitchen, a living room, and multiple outdoor shaded areas.

LPA Kim toured inside and outside of the physical plant with OPMAN Infante. There are no obstructions or bodies of water 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, Resident Room 4, and Resident Room 5. Bathrooms were found to be clean and operational. The water temperature measured between 122.5 degrees F and 122.9 degrees F. During the visit, the facility would adjust the water temperature to be measured between 114.6 degrees F to 119.3 degrees F. A comfortable temperature of 74 degrees F was maintained in the facility. LPA Kim observed the facility to be sanitary and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and not accessible to residents