Facility Evaluation Report

Licensing Program Analyst (LPA) David Marrufo conducted an unannounced Required 1 Year visit and met with Jesus Gomez.

During visit, LPA toured the facility inside and out.

LPA toured the activity areas and observed there to be facility staff supporting clients at various activity stations. LPA toured the facility bathrooms. Each bathroom had working lights and available soap and hand drying machines. The water temperatures in the bathrooms ranged from 105 F to 106 F.

LPA reviewed the Centrally Stored Medication and Destruction Records (CSMDR) for five out of five clients who keep medications at the facility. All CSMDRs were complete.

LPA reviewed seven resident records and seven staff records and found them to be complete.

The fire alarm panel had an inspection sticker that indicated the fire alarm system was checked by a professional on April 10th, 2025. The Emergency Disaster Drill Log indicates the last drill was conducted on 09/02/2025. LPA reviewed the first aid kit and found it to be complete.

See LIC809-C page for more information. Page 1 of 2.