Facility Evaluation Report

Licensing Program Analyst (LPA) Michael Hood arrived at the facility and met with Administrator, Stephanie Baltar Cascasan, to conduct a Pre- Licensing visit. The facility has a fire clearance for three (3) non-ambulatory residents and three (3) bedridden residents with a hospice waiver for two (2) residents. Administrator has an active certificate (#7028782740 with expiration date 8/14/2026).

LPA conducted an inspection of the care home to ensure compliance with Title 22 regulations. There are four (4) bedrooms and two (2) bathrooms for resident use. Bathrooms were in sanitary condition and properly maintained. Hot water temperature was observed to be 116.5 degrees F. LPA observed facility has the ability to prepare and store food, to lock away cleaning products and other toxins, and lock medications to make inaccessible to residents. LPA observed smoke detectors and carbon monoxide detectors to be operational in the care home. First aid kit is maintained and ready for emergency use.

Component III was completed. Application is pending and LPA will forward findings to the Centralized Application Bureau (CAB) for final review and approval. CAB will further contact applicant on final status of application. A copy of this report was provided to the facility. Exit interview conducted.