Facility Evaluation Report

On August 4, 2025, at 1:30 PM, Licensing Program Analyst (LPA) Edward Kim conducted an unannounced required 1-Year annual visit using the CARE Inspection Tool. Upon arrival at the facility, LPA Kim met with House Manager (HM) Rosallie Gabriel. A phone call was attempted to Administrator (AD) Juhayna Diaz. ADMIN Diaz did not respond and who could not attend today's visit. HM Gabriel signed on behalf of the facility because ADMIN Diaz was absent from August 1, 2025, to August 4, 2025..

The facility is licensed to operate for six (6) non-ambulatory residents and have a hospice waiver for four (4) residents. The facility is a two-story building located in a residential neighborhood. It consists of the following: four (4) resident bedrooms, five (5) staff bedrooms, six (6) bathrooms, living room, family area, dining room, office, kitchen, attached 2-car garage, and 2 outside covered patio areas.

LPA Kim toured indoor and outdoor of the physical plant with HM Gabriel. There are no obstructions or bodies of water on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for each resident’s personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. All bedrooms were inspected: Resident Room 1, Resident Room 2, Resident Room 3, Resident Room 4, Staff Room 1, Staff Room 2, Staff Room 3, Staff Room 4, and Staff Room 5. Bathrooms were found to be within Title 22 regulations and were clean and operational. Bathroom water temperature measured between 107.6 degrees F and 108.1 degrees F. A comfortable temperature of 76 degrees F was maintained in the facility.