Facility Evaluation Report

On April 22, 2026, at 9:00 AM, Licensing Program Analyst (LPA) Edward Kim conducted an unannounced case management visit for a Health and Safety check. LPA Kim met with Caregiver (CG) Juwita Elisabeth. LPA spoke with Administrator (ADMIN) Heddy Mae Oyson over the telephone and explained the purpose of the visit. ADMIN Oyson stated they could not attend today's visit and that CG Elisabeth could sign in behalf of the facility.

LPA Kim conducted a health and safety check. During the visit, LPA toured the facility and observed the following: LPA observed two staff on duty providing care to five residents. Facility maintained ample 2-day perishables and 7-day non-perishables in the kitchen. Staff stated food gets delivered one time per week. Resident hygiene supplies are stored in their bathrooms and extra supplies in the garage. The hot water temperature measured at 116.9 degrees F. The indoor temperature measured at 73 degrees F. All smoke detectors and carbon monoxide detectors were operational. All emergency disaster supplies were prepared and available in the garage. Facility land line (714) 646-9615 was tested and remains available. No obstacles observed in the backyard. All staff on LIC 500 are cleared and associated to the facility. Residents interviewed stated satisfaction with facility services and denied any issues with food supply or utilities. LPA conducted interviews with two residents and two staff. LPA observed valid certificate of liability insurance effective April 2, 2026, and expires on April 2, 2027. During the visit LPA Edward Kim cleared a deficiency from an Annual Visit dated April 8, 2026, of R1's hole in their wall. The hole was patched up and good condition.

An exit interview was conducted, and a copy of this report and POC Clearance letters were provided to Caregiver Juwita Elisabeth..