Facility Evaluation Report

Licensing Program Analyst (LPA) Claudia Gutierrez made an unannounced visit for the purpose of conducting a Required/Annual Inspection. LPA was greeted and granted entry. LPA met with Staff Anthony “Tony” De Guzman and explained the purpose of the inspection.

During the inspection, LPA and Staff De Guzman conducted a tour of the inside and outside of the facility, common areas, resident rooms, kitchen, garage and observed the following:

This is a one-story home with five resident bedrooms, two staff bedrooms, three bathrooms, and attached two-car garage. LPA observed staff is currently residing in the garage; a Deficiency was cited on today’s date. All resident bedrooms had the required furnishings. LPA observed all residents’ beds had linens and blankets. The backyard has a shaded sitting area. LPA observed residents watching television in the living room and resting in their respective bedrooms. Bathrooms were observed to be free of debris and mildew, and faucets and toilets were operational. The water temperature tested at 107.2 degrees Fahrenheit. LPA observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable food as required by regulations. Smoke detectors and carbon monoxide detectors tested operational. Fire extinguisher was observed to be fully charged with service tag dated January 9, 2026. Gas stove, microwave, washer, and dryer were all inspected and observed to be operable. Toxic chemicals, cleaning solutions, and disinfectants were observed to be inaccessible to residents. Medication was observed to be centrally stored and locked. LPA reviewed five of five resident files and two staff files. LPA observed a staff file is not being maintained for one of three staff present; a Deficiency was cited on today’s date. Two of two staff files reviewed did not contain any documentation for initial medication staff training; Deficiencies were cited on today’s date. (Cont. LIC809-C)