Facility Evaluation Report

Licensing Program Analyst (LPA) Jose De La Cruz made an unannounced visit to conduct a Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit with Licensee Roger Villalobos. The facility's license shows a maximum capacity of four (4) ambulatory residents.

LPA arrived at 8:00 am, facility looks clean and in good repair. At 8:10 am LPA requested residents files, and at 8:14 am, C1, C2 and C3 got out of their rooms and said hi. At 9:30 am, LPA requested staff files, and at 10:15 am reviewed facility documents.

At 10:25 am, LPA and Licensee toured the facility, inspected the interior and exterior. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, windows, screens, toilets, and showers were in working order. Extra linen and hygiene supplies were present at the laundry room, as well as Personal Protective Equipment. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. The facility contained at least 2 days of perishable food, and at least 7 days of non-perishable food, all safely stored. Cooking, dining equipment, and utensils were present.

Water temperatures were measured Fahrenheit degrees, 113.9 for the sink, 114.6 and 110.1 for each bathroom.