Facility Evaluation Report

Unannounced Annual Inspection visit was made by Licensing Program Analyst (LPA) Kimberly Viarella to this facility on 12/20/24. LPA identified herself upon arrival, stated the purpose of the visit. LPA met with Jerry Abengana and a brief interview followed. LPA requested the following documents:

·LIC 308: Designation of Administrative Responsibility

·LIC 309: (for any LLC or Corp) if applicable

LPA noted the Administrator's certificate # 7026319735 and it expires on 10/08/25.

The LPA inspected the kitchen. All knives and sharps were locked and inaccessible to residents in care. The food supply was adequate for 2-day perishable and 7-day nonperishable. All food items were dated, labeled, and stored according to regulations.

The fire extinguisher was last serviced on 11/08/24 by Hogue Fire Protection and was in compliance at the time of inspection.

LPA inspected resident rooms. All 4 rooms were single occupancy and had the required furniture, furnishings and lighting to be in compliance at the present time. The doors to all of the rooms were also equipped with locks for residents to use if they so chose.