Facility Evaluation Report

On July 30, 2026, at 9:30 AM, Licensing Program Analyst (LPA) Avelina Martinez made an unannounced visit to this facility to conduct an annual required inspection. LPA Martinez met with Agdigos and explained the purpose of today's visit.

LPA Martinez inspected the physical plant including but not limited to the kitchen, dining room, resident bedrooms; resident bathrooms, laundry room, activity room, and outside courtyards of the facility to ensure compliance with Title 22 regulations.

Administrator holds current certificate. The facility is licensed for six ambulatory clients. There are currently five clients who reside at this facility. LPA Martinez toured the facility with Marybel Agdigos on July 30, 2026, at 9:00 AM.

LPA Martinez reviewed two staff files and two client files. All staff files were maintained and complete. LPA Martinez reviewed one medication administration record. The facility has an infection control plan and a natural disaster plan. The last fire drill was on July 17, 2026. The smoke detectors and carbon detectors are in good repair. The facility common areas, bedrooms, and bathrooms were furnished and in good repair. The facility kitchen was sanitary and had adequate food supply. The facility has a first aid kit and client medications were stored in a locked closet. The exterior of the home is clear of debris, and the emergency exit gate is in good repair. The facility has a shaded patio for client use. The water temperature measured at 105 degrees, and the facility temperature measured at 76 degrees. Please email the following documents to LPA Martinez by August 06, 2026, by 5:00 PM: Surety Bond certificate; Current Liability Insurance; LIC 308 Designation of Administrative Responsibility; LIC 500 Current Personnel Report; Copy of current Administrator Certificate. Based on this annual inspection, there were no deficiencies cited, and an exit interview was conducted, and copy of this report was provided to the facility.