Facility Evaluation Report

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced annual inspection visit, and met with Administrator (ADM) Marites Gonzaga. LPA toured the facility inside and out with ADM. License, Administrator Certificate, and personal rights posters were observed in the facility. 5 residents and 2 staff were observed in the facility. 1 resident went to day program. LPA reviewed 3 resident file and 3 staff files.

Living Family room, kitchen, dining area, 2 restrooms, garage, and laundry rooms were inspected. 2 single resident bedrooms, 2 shared resident bedrooms, and 1 staff room inspected. Two day perishable food supplies and seven day nonperishable food supplies were observed sufficient. knives closet and dish washing solution closet were observed locked. The temperature of the refrigerator was observed at 35 degree F and the temperature of the freezer was observed at 0 degree F. Medication closet, knives closet, and chemical closet were observed locked. Room temperature was at 70 degree F, and hot water temperature was at 113 degree F in facility.

Fire extinguisher was serviced on 4/21/2026. The facility was equipped with fire alarm system, smoke and carbon monoxide detectors. Carbon monoxide detectors were tested by ADM, and were working. First aid box, night lights, and flash lights were observed in the facility. Front yard and backyard were inspected. There was no obstruction to block the walkways. The last time the facility conducted the emergency and fire drill was on 4/10/2026.

No citation noted today. Exit interview was conducted with ADM. This report was provided to ADM for signature. A copy of the report was provided to ADM.