Facility Evaluation Report

On 4/22/24, at 10:37am, Licensing Program Analyst (LPA) Arvin Villanueva arrived to this facility unannounced to conduct a pre-licensing visit. LPA initially met with a staff on duty and explained the purpose of the visit. The licensee and administrators, Amy Rose Caridad, Jayson Caridad and Grace Foundo were notified of the visit and arrived shortly after. During this visit, present were 2 residents in care with 2 staff on duty. The facility has an approved hospice waiver for 4 residents. Additionally, the facility is fire cleared for 6 non-ambulatory residents.

At 10:45am, LPA and staff on duty toured the physical plant of the facility. The facility is a single-story home located in a residential neighborhood. Physical plant is consistent with the submitted facility sketch/floor plan. Facility temperature was observed to be at 79 degrees F upon arrival. Indoor and outdoor passageways are free of obstruction. Entrances/exits, ramps, open porches and backyard are well-lit. There are no bodies of water was observed. The side gate is self-latching and in good repair. Disinfectants, cleaning supplies, toxic products, and sharp objects were all observed to be locked and inaccessible to resident in care. Fire alarm and carbon monoxide detectors were observed to be operating properly. The backyard is secure and has adequate space for outdoor activities. LPA observed laundry supplies and equipment including washer and dryer and are observed to be in good repair.

There are 6 resident bedrooms and 1 staff room. All bedrooms were observed to be fully furnished, clean and in good repair. There is appropriate lighting in the facility and in each room. Residents bedrooms were observed to be large enough to allow passage between and comfortable usage of beds and other required furniture. Currently 3 of the 6 resident bedrooms are unoccupied.