Facility Evaluation Report

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced annual inspection visit, and met with House Manager (HM) Ernie Manaois.

LPA reviewed 4 resident files and 3 staff files. LPA observed 4 residents and 1 staff in the facility.

LPA toured the facility inside and out with HM. License, Administrator Certificate, and Personal Right posters were observed in the facility. Family room, dinning room, kitchen, office, laundry room, 3 resident single rooms, 3 resident shared rooms, 2 staff live-in rooms, and 3 restrooms were inspected. Room temperature was at 70 degree F, and hot water temperature was at 119 degree F. The temperature of the refrigerator was at 37 degree F, and the temperature of the freezer was at 0 degree F. Two day perishable food supplies and seven day nonperishable food supplies were observed sufficient. Knives closet, medication closet, and cleaning product closet were observed locked. The facility is equipped with smoke and carbon monoxide detectors. HM tested the smoker detectors, and they were working fine. Fire extinguisher was serviced on 7/30/2025.

LPA observed the first aid box and flash lights, and night lights in the facility.

The facility had emergency drill on 10/28/2025. Front yard and backyard were inspected. There was no obstruction to block the walkways.

No citations were noted today. Exit interview was conducted with HM. A copy of this report was provided to HM.