Facility Evaluation Report

On August 22, 2025, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced annual inspection. LPA met with Administrators, Anthony Diaz and Bella Terciano 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 six resident rooms; all of which are private resident rooms. Resident rooms were observed to be clean with all required furniture. There is one staff room. Two full bathrooms were observed to be clean, odor-free and in good repair. Water temperature throughout the facility measured between 108-114 degrees F. Extra linen was observed to be present. First aid kit was observed to be complete.

Dining room was observed free from tripping hazards. A comfortable temperature is maintained and lighting is sufficient for comfort. LPA observed two day perishables, however did not observe seven day non-perishables. Medications and chemicals were observed locked an inaccessible to residents in care. Sharps were observed unlocked and accessible to residents. Sharps were immediately locked by caregiver.

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

July 2024. LPA reviewed 5 resident records and 5 staff records. Medication review was done, and all medications are accounted for, and centrally stored medication records are updated.

Based on observation, deficiency is cited under California Code of Regulations, Title, 22 cited on the LIC 809D. Failure to correct the deficiencies may result in civil penalties. Report is reviewed with Administrator and a copy is provided.