Facility Evaluation Report

Licensing Program Analyst (LPA) Jessica Cho arrived 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 Alex Jimenez and explained the reason for the visit. Administrator (Admin) Juan Reyes arrived shortly to assist with the inspection. Admin holds a valid administrator's certificate expiring on December 2, 2026.

The facility is a single story structure and is licensed to provide services for age range 60 and over for six non-ambulatory residents. A waiver was granted to provide hospice services to four residents at one time. During today's visit, there are five residents of which two are under hospice care and two staff on duty.

LPA toured the physical plant with Admin Reyes. Facility is clean, sanitary, and in good repair. LPA observed five resident bedrooms and two resident bathrooms. Resident bedrooms had all required furnishings. Bathrooms were found to be in compliance, clean, and operational. The hot water temperature measured at 105.0 degrees Fahrenheit in both bathrooms. All common areas were inspected including the attached two car garage. LPA reviewed the Emergency Disaster Plan (LIC610E) and observed sufficient emergency food and water in the garage. Toxins, disinfectants, sharps, and medications were secured and inaccessible. LPA observed sufficient two-day supply of perishables and seven-day supply of non-perishable food available in the kitchen. LPA toured the exterior portion of the facility. The outdoor passageway is free of obstruction. The exit gates are self-closing and self-latching. LPA observed sufficient seating and shading.

The fire extinguisher was mounted and serviced on December 12, 2024. The auditory devices and smoke/carbon monoxide detectors were tested and operational.