Facility Evaluation Report

On 7/23/2025, Licensing Program Analyst, Arvin Villanueva (LPA) arrived unannounced at this facility to conduct their annual inspection visit. LPA met with Administrator Angelica Fernandez (S1), and stated the purpose of the visit.

Overview : Facility is a one-story home located in a residential neighborhood. Facility is licensed to serve up to 6 elderly residents. All 6 bedrooms were approved for non-ambulatory use. Facility does not have bedridden clearance at this time. Facility has approved hospice waiver for 3 residents.

Initial Observation: Present during this visit were 5 residents in care with 3 staff on duty (S1, S2, S3). LPA was greeted by one of the staff on duty (S2) and one resident in care. LPA observed required posters and facility license at the entrance. Room temperature was at 73 degrees Fahrenheit upon arrival. Another staff on duty (S3) was observed to be preparing food for residents.

Areas inspected include, but not limited to, the kitchen, resident bedrooms, resident bathrooms, living and dining room and outdoor areas. LPA observed the inside of the facility to be clean and in good repair at this time. LPA inspected 4 of 5 resident bedrooms and were observed to be equipped with the required furniture and sufficient lighting throughout. Each bedroom is equipped with smoke detectors. Bedroom #5 is currently vacant. LPA measured the hot water temperature in the 1 of 3 bathrooms to be at 108.5 degrees Fahrenheit. Resident bathrooms were observed to be in clean and good repair at this time. There is a fire door leading to bedrooms #1-3. The fire door was observed to be closed during this visit. Bedrooms #1 and #2 have shared bathrooms.