Facility Evaluation Report

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct an annual inspection and met with Lourdes de la Paz, Administrator, and stated the reason for today's inspection. Also present were staff, Jovylito Madum, Fe Luzse Abata, and Dennis Abadilla. The facility is a specialized RCFE facility vendorized through Alta California Regional Center, licensed for (4) non-ambulatory residents, (2) of whom can be bedridden. There were (4) residents present. There is an approved hospice waiver for (2). Currently (1) resident under hospice care.

LPA and the Administrator toured the interior/exterior of the facility including the common areas, (4) resident bedrooms (2.5) bathrooms, kitchen, activity room, staff room, laundry area and garage. The facility was clean, very organized, in good repair and odor-free. The bathrooms have the necessary grab bars, slip-resistant flooring, and hygiene supplies . There is sufficient 2+day perishable, including fresh produce, and 7+day non-perishable food. There are alerts on each exit door. There is a music therapist, recreational therapist and nurse that visit weekly. (3) clients currently attend day program. The smoke/monoxide alarm is in working order. Fire extinguisher was last serviced 6/24/25. Sharps, toxins and medications are locked in the kitchen. Inside temperature measured 70*F, and the hot water temperature measured 114*F in a resident bathroom. There are (2) unlocked exit gates and outside seating with shade. All required posters are visible in the common area. There is a complete First Aid kit.

LPA reviewed (2) client files and (4) staff files. Files were organized, complete and had current documentation. Medications and orders were reviewed for (1) client -no discrepancies noted. P&I was confirmed for (2) residents. The surety bond- expires 4/26/26. Staff has completed the required continuing education. Administrator RCFE Certificate #7035764740- exp 7/12/26. Updated copy of liability insurance and LIC500 obtained. There are no deficiencies. Copy of report provided to the Administrator.