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 Mark Alex and explained the reason for the visit. Future Licensee (FL) Albert Dahbour arrived on site to assist with the visit. Elizabeth Joaquin, Administrator, holds a valid certificate expiring on September 22, 2026.

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

LPA toured the physical plant with FL Dahbour. Facility is clean and operational. LPA observed six resident bedrooms and three resident bathrooms. There is one additional staff bedroom occupied by two live in staff. Resident bedrooms had all required furnishings. Bathrooms were found to be in compliance, clean, and operational. The hot water temperature measured at 111.2, 114.6, and 110.6 degrees Fahrenheit. 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 gate is self-closing and self-latching. LPA observed sufficient seating and shading.