Facility Evaluation Report

On September 3, 2025, Licensing Program Analyst (LPA) Murial Han conducted an unannounced annual inspection. LPA met with caregivers, Angelina Cruz and Sherry Williams. LPA explained the purpose of today's visit. The co-administrator, arrived shortly thereafter and assisted with the inspection.

LPA toured the facility inside out and inspected the living room, dining area, kitchen, bedrooms, bathrooms, garage and backyard. This is a single story home with 3 shared resident bedrooms, 2 full bathrooms, and two staff rooms. The indoor and outdoor passageways were free of obstruction. Furniture and furnishings were observed to be sufficient. Food supplies were sufficient of 2- days perishables and 7- days of non-perishables. Toilet, hand washing and bathing areas were observed clean and in operating condition. Showers observed to be in good operation condition. Comfortable temperature is maintained and lighting is sufficient for comfort.

Bed sheets, linens, and towels were observed to be sufficient and able to meet the needs of the residents at this time.

Central storage for medications, sharps and chemicals were observed to be locked and inaccessible to residents in care.

Hot water temperature in the kitchen and bathroom were measured at 105-115 degrees Fahrenheit. Fire extinguishers were checked and last inspected on 5/6/2025.

A review of (5) resident files was conducted and noted on the LIC 858.

A review of (3) staff files was conducted and noted on the LIC 859.

During today's visit, LPA requested documents to update the facility administrator, written letter from the licensee appointing the co-administrator as the administrator on record, LIC 308 (Designation of Facility Responsibility), LIC500 and a copy of the administrator certificate.

No deficiency is cited today; this report is reviewed and discussed with co-administrator a copy is provided.