Facility Evaluation Report

Licensing Program Analyst (LPA) Hiratsuka, conducted this unannounced at the facility to conduct an annual inspection. LPA toured with Caregiver Purificacion Tuazon. Administrator Bella Cabultotan arrived during visit.

LPA and Caregiver conducted a tour of the interior of the facility to ensure the health and safety of clients in care. Areas toured included but not limited to: three shared client rooms, bathroom, staff room, garage, kitchen and the common areas. LPA observed facility to ample supply of clean linens. LPA observed facility to have ample supply of perishable and nonperishable foods. LPA observed sharps, toxins and medications to be locked and secured. In areas toured, no immediate health and safety concerns observed.

LPA conducted file review for three clients and three staff files. All files have the required paperwork.

The following information from the facility shall be updated and submitted by April 30, 2026:

-LIC 308 Designation of Administrator Responsibility

-letter from Licensee designating the Administrator, a copy of administrator's certificate, and organizational chart with the administrator's name on it.

As a result of today's visit, no deficiencies cited.

Exit interview and a copy of report was provided.