Facility Evaluation Report

Licensing Program Analyst (LPA) Marcela Yanez conducted an unannounced Required 1 Year visit and met with Domingo Bonifacio, Lead Staff (LS). LPA announced the purpose of the visit. ADM arrived at facility at the end of inspection. LPA observed 5 residents and 3 staff.

During visit, LPA toured the facility inside and out. LPA observed the kitchen area and observed locked cabinets for medications, sharp objects, and cleaning supplies. LPA observed perishable food supply of at least two days and a non-perishable food supply of at least seven days.

LPA toured resident bedrooms. Each bedroom had available bedding and clothing storage areas as well as functioning lights. Lead Staff tested the smoke detector found the smoke detector and found to function properly when tested. LPA toured 3 out of 3 resident bathrooms. Each bathroom had available soap and paper towels and functioning lights. The water temperatures in the bathroom sinks measured with thermometer at F. 104.9-142 degrees F, ADM stated it was a new water heater, LPA reminded ADM water needs to be between 105-120 degrees F, and water above 125 degrees F should have a warning sign.

LPA toured the outside area and found the exits to be clear of obstructions. LPA observed fire extinguisher was last serviced on 10/10/25. LPA reviewed Fire and Earthquake log, last drill was conducted on 12/09/25.