Facility Evaluation Report

On June 22, 2026, Licensing Program Analyst (LPA) Garlli Tat conducted an unannounced visit to the facility for the purpose of a required annual inspection. LPA explained the purpose for the visit and was greeted and granted entry by staff on duty. During the visit, staff on duty contacted the facility administrator (AD) Jennifer Perez about the visit. For this visit, there are three staff members on duty, all of which are background cleared and associated. AD later arrived to assist with the inspection.

The PUB475 ‘See Something, Say Something’ poster was observed to be located near the front entrance. LPA observed that Jennifer Perez has a valid Administrator certificate which expires on January 1, 2027.

The facility is a Residential Care facility for the Elderly (RCFE) licensed for six residents, five of which may be non-ambulatory, one of which may be ambulatory, none may be bedridden, and a hospice waiver for three. LPA toured the interior and exterior portions of the facility with AD. For this visit, there are a total of four non-ambulatory and one ambulatory residents in care, one of which is on hospice, and none are bedridden.

The facility is a single story home. There are a total of six bedrooms, all of which are private resident bedrooms. LPA toured each bedroom with the AD and observed that bedrooms were provided with furniture in good repair, clean linens, adequate storage space, and free of any hazards. Smoke and carbon monoxide detectors as well as auditory exit alarms were tested and operational. There are a total of two bathrooms for residents and staff.