Facility Evaluation Report

Licensing Program Analyst (LPA) Michael Hood met with Acting Administrator, Michael Magpusao, to conduct a Pre- Licensing visit. This application is a change of address. The previous license is named VILLA SIERRA LODGE - SPENLOW Facility #: 342700523. The facility has a fire clearance for four (4) ambulatory residents. Administrator Lualhati Magpusao has an active certificate (#6022281735 with expiration date 12/18/2024).

LPA conducted an inspection of the care home to ensure compliance with Title 22 regulations. There are four (4) bedrooms and three (3) bathrooms for resident use. Bathrooms were in sanitary condition and properly maintained. Hot water temperature was observed to be 119.2 degrees F. LPA observed facility has the ability to prepare and store food, to lock away cleaning products and other toxins, and lock medications to make inaccessible to residents. LPA observed smoke detectors and carbon monoxide detectors at the care home to be operational.

Component III was waived. Application is pending and LPA will forward findings to the Centralized Application Bureau (CAB) for final review and approval. CAB will further contact applicant on final status of application. A copy of this report was provided to the facility. Exit interview conducted.