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 Bonifacio Mercado and explained the reason for the visit. Administrator (Admin) Rowena Carillo arrived approximately 12pm. LPA observed two caregivers on duty providing care to six residents of which three are under hospice care. The Administrator's Certificate for Rowena Carillo expires on June 24, 2027 and June 3, 2027 for Administrator Angeline Delos Reyes.

The following was observed during the inspection:

This is a single story structure located in a residential neighborhood. Facility operates within the conditions and limitations specified on the license. There are six private resident bedrooms and four resident bathrooms. 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 109.5,107.7, 105.0, and 107.4 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 obstruction. The shed stores mattresses which is inaccessible to the residents. The two exit gates were operational and there were sufficient seating and shading. The fire extinguisher was purchased on today's date per review of the receipt. The auditory devices in two residents' rooms, Resident #1 (R1) and Resident #6 (R6) were not operational. The dual functioning smoke/carbon monoxide detectors were tested and operational.