Facility Evaluation Report

On October 9, 2025, 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 facility administrators (AD) Rosa Reyes and Johan Mathews. For this visit, there are two staff members on duty, both are background cleared and associated.

The PUB475 ‘See Something, Say Something’ poster was observed to be located by the kitchen. LPA observed the Administrator's Certificate for Rosa Reyes, which expires on April 11, 2026.

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

The facility is a two-story home. There are a total of five bedrooms, two of which are shared resident rooms on the first floor, and three as staff bedrooms on the second floor. 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 three bathrooms, one is for residents on the first floor and two are for staff on the second floor.

Bathrooms were observed to be in good repair, toilets and faucets were operational and showers were equipped with grab bars and non-skid floor mats. Water temperature in the bathroom was measured to be 111.0 degrees Fahrenheit. Continued on LIC 809-C.