Facility Evaluation Report

Licensing Program Analyst (LPA) Jason Lund arrived announced to conduct an one year required visit. LPA Lund was met by Administrator Paulina Teca Joao and explained the purpose of the visit. Census: 0

This facility will be licensed to hold 4 residents, of which 4 may be ambulatory. This facility is also awaiting vendorization from Valley Mountain Regional Center and will accept and hold Level 6 residents.

A tour/inspection of the facility was conducted. Smoke detectors and carbon monoxide detectors were tested and are in good repair. A tour of the kitchen area was toured. This facility will have a locked medication cabinet located in the hall. A first aid kit was observed and had all the required components. Fire extinguisher was located in kitchen and was serviced on 11/13/2025 by the local fire company, Coast Fire Equipment Co. A tour of the family room was conducted. Furniture and furnishings were observed to be in good repair. A tour of the backyard was conducted with no hazards present. Perimeter gate was observed to be in good repair. A tour of garage was conducted. A washer and dryer was identified. Detergent, toxins and other cleaning supplies were observed to be locked and made inaccessible. A tour of the resident bedrooms were conducted. Furniture and furnishing were observed to meet the residents needs. A linen closet was located in hallway and was observed to have a sufficient amount of linen to meet the residents needs at this time. A tour of two resident restrooms were toured.

As a result of this annual visit, the facility is in compliance with Title 22 Regulations, a copy of the LIC 809 reports, were provided to the facility.