Facility Evaluation Report

Licensing Program Analyst (LPA) Mary Rico conducted an announced visit to the facility for the purpose of a change of ambulatory, non-ambulatory and bedridden. LPA was greeted and granted entrance by caregiver Maria Victoria Corcuera.

Per the LIC200, Licensee requested for the change of ambulatory, non-ambulatory and bedridden. The facility went from (0) bedridden to (1) bedridden. For ambulatory from (6) to (4) ambulatory residents. In addition, for non-ambulatory from (0) to (1). The fire clearance request was approved on 10/22/2024 for (1) non-ambulatory, (4) ambulatory clients and (1) bedridden.

The licensee was advised that the noted designated capacity and status for each room is to remain in compliance.

LPA observed that the residents’ bedrooms were appropriately furnished and had functional lighting. The physical plant is ready. LPA will update the facility's file and issue a new license.

An exit interview was conducted where this report LIC809 was discussed and provided to caregiver Maria Victoria Corcuera and Administrator Simm K. Sanashinh.