Facility Evaluation Report

On August 6, 2025, Licensing Program Analyst(LPA) Murial Han conducted an unannounced annual inspection. Upon arrival, LPA was greeted by caregiver, Jeff Rocaberte and LPA explained the purpose of today's visit. The administrator, Roger Fujii arrived shortly thereafter and assisted with the inspection.

LPA toured facility and grounds. No accessible bodies of water or fire safety hazards observed. LPA toured the facility inside and outside including all of resident rooms, common areas, and kitchen area. The indoor and outdoor passageways were free of obstruction. Facility was overall clean and odor-free. Comfortable temperature is maintained and lighting is sufficient for comfort.

This is a two story facility. On the ground level, LPA observed four private resident rooms and one office. On the 2nd floor, LPA observed a large staff room that is separated by two privacy curtain into 3 individual spaces. The 2nd floor also has a full bathroom and a closet. LPA observed the resident rooms were spacious and included all required furnishings. Two full bathrooms were observed to be clean and in operating condition. Hot water temperature was measured at 105-110 degrees F in the kitchen and resident bathrooms.

LPA observed medications, toxins and sharps to be locked and inaccessible to residents in care. 2 days for perishables and & 7 days non-perishable were observed to be present.

A review of (4) resident files was conducted and noted on the LIC 858.

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