Facility Evaluation Report

On June 12, 2026, Licensing Program Analyst (LPA) Jenifer Tirre conducted an unannounced required visit using the CARE Inspection Tool. LPA was greeted by staff and granted entry after stating the purpose of the visit. Staff contacted Administrator and Administrator Clemencia Atencio arrived shortly after and was available to assist with the facility inspection.

The facility is licensed for six (6) non-ambulatory residents with approved hospice waiver for six (6) residents. Currently, there are four (4) Hospice residents present during today’s visit.

This is a single story home with attached garage facility. The facility has six resident bedrooms, seven bathrooms, one staff room and one staff office.

LPA conducted a tour of the physical plant accompanied by Administrator Atencio, and the following was observed: There were no bodies of water on the premises. All rooms were inspected. Beds and bedding supplies were in operational condition, lighting was provided, and storage for the client's personal belongings was observed. Bathrooms were operational with water temperature measured between 109.5 to 115.3 degrees F. A comfortable temperature of 78 degrees F. was maintained in the facility.

LPA observed the facility to be furnished at the time of the visit. Storage areas for cleaning supplies and sharps objects were stored and not accessible to residents. The kitchen was inspected, and sufficient perishable and non-perishable food was maintained adequately. Facility has three fire extinguishers which were fully charged and mounted. A review of the Medication Records Administration (MAR) was conducted, and LPA observed the records are in compliance. CONTINUED ON 809C