Facility Evaluation Report

Licensing Program Analyst (LPA) Santino Fortes conducted an unannounced annual inspection, and met with Administrator (ADM) Dominica Oliva. ADM stated facility has 2 staff and 5 clients.

LPA toured the facility inside and out. There were 6 resident rooms (shared/single), 2 staff rooms, 1 living room, 1 family room, and Kitchen. LPA observed resident rooms each with a chair, night stand, sufficient lighting and chest of drawers. Room temperature was 73.7 * F. Hot water temperature was Bathroom, 113.5*F, Bathroom 114* F and kitchen 113.5* F. LPA observed the first aid kit to be complete. Smoke and carbon monoxide detectors functioned properly when tested. Fire extinguishers were serviced on 5/9/25 and 5/20/25. Staff conducted a fire drill on 4/10/25. Restrooms observed to have non skid flooring. LPA observed 2 days perishable food supply and 7 days non-perishable food supply. Refrigerator temperature observed at 34* F and Freezer temperature -7* F. LPA observed medication storage, knives storage, and cleaning product storage locked and inaccessible to clients in care.

The front and back yards of the facility were inspected. Exits and walkways were unobstructed. Facility has NO storage sheds, and Garage is used to store beds, shelving, wheelchairs and care supplies.

LPA observed Facility License and Resident Personal rights were posted. Due to time constraints inspection was not able to be completed.

No deficiencies were cited during today's visit as per California Code of Regulations Title 22. Exit interview was conducted with ADM. This report was reviewed and a copy was provided to ADM for signature.