Facility Evaluation Report

Licensing Program Analyst (LPA) Kesha Lewis arrived at the facility to conduct a case management on a Pre licensing inspection on Alexa Home. This is a follow up visit from visit on 01/09/2026. LPA met with caregiver and attempted to call the Administrator, who arrived at 10:30. The purpose of the visit was explained.

Current census is 5 residents, 0 are receiving hospice, 4 of 5 are receiving home health care specifically PT, 4of 5 are insulin dependent with a sliding scale. No current catheters, No current colostomy and No current Wounds.

LPA verified staff present are fingerprint cleared. LPA toured the facility which included a staff room with 2 sets on bunk beds, and 4 resident rooms. The exterior of the building shows one screen which needs to be replaced and a manicured lawn. The interior living area is clean. bathroom 2 has pink mold growing in the shower. The bathroom has the necessary DME. Facility has required linen, lighting and furniture.

Facility appeared clean and well kept otherwise.

The facility has the necessary food, however the proper labeling of food once opened is not being completed.

All LIC602s are signed off by the Medical group out of San Rafeal, documentation of medical visits occurring in the home are documented in the electronic record.

R2 was observed to need assistance repositioning in bed which would require bedridden clearance. The facility currently has no fire clearance for this.