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 Tedjo Pranoto followed by Licensee/Administrator (Admin) Aurica Bintintan after explaining the purpose of the visit. The facility is a single story structure located in a residential neighborhood. Facility operates within the conditions and limitations specified on the license. LPA observed two caregivers on duty providing care to six residents of which one is under hospice care. The Administrator's Certificate for Aurica Bintintan expires on March 25, 2026.

The following was observed during the inspection:

There are five resident bedrooms and five resident bathrooms. There are two additional staff bedrooms and one private staff bathroom in the master room. All common areas were inspected including the attached two car garage. The residents' bedrooms were appropriately furnished. Beds and bedding supplies were in good condition, adequate lighting was provided, sufficient storage space for each residents' personal belongings were observed. Bathrooms were found to be in compliance, clean, and operational. The hot water temperature measured at 115.5, 117.3, 117.6, 118.7, and 117.5 degrees Fahrenheit in the resident bathrooms. 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. LPA toured the exterior portion of the facility. LPA observed the outdoor passageway is free of obstructions. The sheds which holds continence supplies, medical equipment, and cleaning solutions in the passageway is inaccessible to the residents. The two exit gates were operational. LPA observed sufficient seating and shading. The fire extinguisher was purchased on September 5, 2025 per review of the receipt.