Facility Evaluation Report

On 7/3/2026 at 9:50 am, Licensing Program Analysts (LPAs) Reza Jamaly and Christina Valerio arrived unannounced at the facility to conduct 1- year required inspection.LPAs initially met with staff one duty and explained the purpose of the visit. The administrator, Grace Bernardino was notified of the visit and arrived shortly after. Pascua Grace assisted with today’s visit. Administrator certificate #7002401740 is and will expire on 09/12/2027 . The current census is 6 with 2 facility staff.

Facility is a one-story home located in a residential neighborhood. Facility is licensed to serve up to six elderly residents, up to six may be non-ambulatory. Facility has a hospice waiver for 3 residents.

Areas inspected include, but not limited to, the kitchen, dining area, resident units, resident bathrooms, laundry room, dining room and outdoor areas to ensure compliance with Title 22 regulations. This facility is a single story building licensed to serve six (6) non-ambulatory residents.

LPAs observed the facility to be free of odor, clean and in good repair. LPAs observed 6 bedrooms to be properly furnished with appropriate bedding and lighting. Adequate linen supply was observed. Grab bars and non-slip mat were observed to be stable and in good repair at this time. There are no bodies of water present.

In the kitchen/dining area, LPAs observed at least 7-day nonperishable and 2-day perishable food items.

LPA inspected medication storage a the corner of the kitchen, at least one medication drawer observed to be unlocked and an antiseptic (Isopropyl Alcohol) was observed inside it.