Facility Evaluation Report

On June 30, 2026, Licensing Program Analyst (LPA) Jenifer Tirre conducted an unannounced required visit using the CARE Inspection Tool. LPA was greeted by staff and granted entry after stating the purpose of the visit. Staff contacted Licensee to notify of visit. Licensee Davina Alipio arrived shortly after and was available to assist with the facility inspection.

The facility is licensed for four (4) non-ambulatory residents with approved hospice waiver for three (3) residents. Currently, there are zero (0) Hospice residents present during today’s visit.

This is a single story with attached garage facility. The facility has four bedrooms and three full bathrooms.

LPA conducted a tour of the physical plant accompanied by staff, and the following was observed: There were no bodies of water on the premises. All rooms were inspected. Beds and bedding supplies were in operational condition, lighting was provided, and storage for the client's personal belongings was observed. Bathrooms were operational with water temperature measured at 112.1 -117.1 degrees F.

LPA observed the facility to be furnished at the time of the visit. Storage areas for cleaning supplies and sharps objects were stored and not accessible to residents. The kitchen was inspected, and sufficient perishable and non-perishable food was maintained adequately. Facility has supply of emergency food and water. Facility has one fire extinguisher which was fully charged and mounted.