Facility Evaluation Report

On March 18, 2026, Licensing Program Analyst (LPA) Brandon Lopez made an unannounced visit to the facility to conduct a Case Management - Health Checks inspection. LPA was greeted and granted entry into the facility by Licensee Allen Medina.

On today's visit, LPA observed the facility currently has no residents in care and is currently vacant. LPA, accompanied by the LI, conducted a tour of the physical plant of the facility. LPA inspected the five resident bedrooms and observed them to be free of hazards. LPA observed the lights in each of the resident's bedroom to be operational. LPA inspected the five bathrooms located in the facility, three of which are dedicated for resident use. LPA observed bathrooms to be clean. LPA observed that a light in one of the five bathrooms is still not operational and has not been fixed. Bathrooms were equipped with grab bars and non-skid floor mats. Hot water temperature measured between 118.7 and 119.6 degrees Fahrenheit.

LPA observed the facility has a two day perishable and seven day nonperishable food supply on hand. LPA observed kitchen appliances to be clean and operational. LPA observed the six burner gas stove lights unassisted. LPA observed the facility has a three day emergency food and water supply stored in the kitchen pantry. LPA observed that the paint in the kitchen pantry area is still peeling and still has not been addressed by the Licensee. LPA observed all of the facilities utilities, such as the electricity, water, gas, and internet, to be operational during the visit.

LPA, accompanied by the LI, conducted a tour of the exterior portions of the facility. LPA observed that the backyard and the side yard located on the southside of the facility have been cleaned, weeds have been addressed, and trees have been trimmed. CONTINUED ON LIC809-C