Facility Evaluation Report

On April 24, 2026, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced annual visit. LPA met with Caregiver, Arsenia Villadarez and explained the purpose of the visit.

LPA toured the facility inside and outside including all of resident rooms, common areas & kitchen. The indoor and outdoor passageway was free of obstruction. No accessible bodies of water of fire safety hazards observed. This is a single story facility. There are four resident rooms; two of which are single private rooms and two that are shared rooms. Resident rooms were observed to be clean with all required furniture. LPA observed 3/4 resident beds to have half bed rails. Two full bathrooms were observed to be clean, odor-free and in good repair. Water temperature throughout the facility measured between 123.6-129 degrees F. First aid kit was observed to be complete.

Dining room was observed free from tripping hazards. A comfortable temperature of 74 degrees F is maintained and lighting is sufficient for comfort. LPA observed two day perishables and seven day non-perishables. Medications, sharps, and chemicals were observed locked and inaccessible to residents in care. LPA observed all four residents' PM medication to be pre-poured into another container.

Carbon monoxide monitors are working properly. All fire extinguishers have been checked and current as of

August 2025. Emergency drills are logged and done every 4 months. LPA reviewed 4 resident records and 4 staff records. Medication review was done, and all medications are accounted for, and centrally stored medication records are updated. Deficiencies of the California Code of Regulations, Title, 22 cited on the LIC809-D. Failure to correct the deficiencies may result in civil penalties. Report is reviewed with Caregiver and a copy is provided.