Facility Evaluation Report

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced annual inspection visit, and met with Administrator (ADM) Michelle Santos. LPA observed 6 residents (R1-R6), 3 staff (S1, S2, S3) in the facility.

LPA toured the facility inside and out with ADM. License, Administrator Certificate, and personal rights posters were observed in the facility. LPA reviewed 3 resident files and 3 staff files.

Family room, living room, kitchen, dining area, 2 restrooms, a staff live-in room, 3 resident rooms, a sun room and garage were inspected. Two day perishable food supplies and seven day nonperishable food supplies were observed sufficient. The temperature of the refrigerator was observed at 40 degree F, and the temperature of the freezer was observed at -2 degree F. Medication closet was observed locked. Knives closet, and dish washing soap closet were observed locked. Room temperature was at 77 degree F, and hot water temperature was at 106 degree F in facility. Fire extinguisher was serviced on 8/14/2025. The facility was equipped with fire alarm system, smoke and carbon monoxide detectors. Carbon monoxide detectors were tested, and were working. First aid box, night lights, and flash lights were observed in the facility.

Front yard and backyard were inspected. 1 storage rooms was observed at backyard. The last time the facility conducted the fire drill was on 8/9/2025 and earth quake drill was on 8/12/2025.

Exit interview was conducted with ADM. This report was provided to ADM for signature. A copy of the report was provided to ADM.