Facility Evaluation Report

Licensing Program Analysts (LPA) Steve Chang conducted an unannounced annual inspection visit, and met with House Manager (HM) Michael Gimeno .

LPA observed 4 residents and 2 staff in the facility. LPA reviewed 2 residents files and 2 staff files. LPA toured the facility inside and out and HM. License, Administrator Certificate, and personal rights posters were observed in the facility.

Living room, kitchen, dinning room, three restrooms, six single resident bedrooms, and laundry area were inspected at the first floor. 4 staff live-in rooms and one bathroom were observed at the second floor. Two day perishable food supplies and seven day nonperishable food supplies were observed sufficient. Medication closet and knives closet were observed locked. Cleaning products were observed locked. Dish washing soap closet under the sink was observed locked. Room temperature was at 73 degree F, and hot water temperature was at 112 degree F. The temperature of the refrigerator was at 40 degree F and the temperature of the freezer was observed at 0 degree F. Door alarms were observed working.

HM tested the call button system and were working. First aid box, night lights ,and flash lights were observed at the facility. The last time the facility conducted the emergency drill was on 6/17/2026.

Fire extinguisher was serviced on 4/14/2026. The facility is equipped with fire alarm system, smoke and carbon monoxide detectors. Carbon monoxide detector was tested by staff, and were working. Front yard and backyard were inspected. There was no obstruction to block the walkways. The garage was observed as a storage room.

Exit interview was conducted with HM. This report was provided to HM for signature.