Facility Evaluation Report

On April 14, 2026, 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 staff on duty. During the visit, the facility administrator (AD) Raymond Mendoza assisted with the inspection. For this visit, there are two staff members on duty, both of which are background cleared and associated.

The PUB475 ‘See Something, Say Something’ poster was observed to be located near the front entrance. LPA observed that Raymond Mendoza has a valid Administrator certificate that expires on January 13, 2028.

The facility is a Residential Care facility for the Elderly (RCFE) licensed for six residents, six 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 five non-ambulatory residents in care, three of which are on hospice, and none are bedridden.

The facility is a single story home. There are a total of seven bedrooms, six of which are private resident bedrooms and one is a staff bedroom. 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. LPA observed the staff room is kept locked and inaccessible to residents in care. Smoke and carbon monoxide detectors as well as auditory exit alarms were tested and operational. There are a total of five bathrooms, four are for residents and one is for staff.