Facility Evaluation Report

On May 18, 2026, Licensing Program Analyst, Arvin Villanueva (LPA), arrived unannounced at this facility to conduct the annual inspection visit. LPA initially met with staff on duty, Maria Corazon Mayberry (S1) and explained the purpose of the visit. The licensee, Mary Anne De los Santos (AD) was notified and arrived shortly after. Present during this visit were 6 residents in care with 2 staff on duty (S1, S2)

Overview : Facility is a one-story home located in a residential neighborhood. Facility is licensed to serve up to 6 non-ambulatory elderly residents. Facility does not have clearance for bedridden, delayed egress, and/or locked interior/exterior. Facility does not manage resident cash resources. Facility has a hospice waiver for 3 residents.

Physical Inspection : Areas inspected include, but not limited to, the kitchen, resident bedrooms, resident bathrooms, living and dining room and outdoor areas.

LPA inspected 5 resident bedrooms and 3 bathrooms. Each bedroom has its own exit to the outside. Bathrooms are equipped with non-skid flooring; faucet, toilet and shower are in working condition. Hot water temperature was 105 degrees Fahrenheit in one of the bathrooms. Room temperature was maintained at 72 degrees Fahrenheit throughout this visit. Advisory provided to obtain a commode for the bathroom labeled “staff” in placed of a grab bar.

Fire extinguisher was observed in the dining/living area and last serviced on 4/1/26. LPA observed adequate amount of linen and towels supplies.