Facility Evaluation Report

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced annual inspection today. Upon arrival, a female Daisy Consulta (DC) opened the door for LPA. DC stated there is no resident in facility. LPA stated LPA needed to go inside to inspect.

LPA met administrator (ADM) Shirley Richards inside the house. ADM stated the facility is non operational. ADM stated ADM, ADM's aunt Lolita Macabadbad (LM) and DC live in this house. ADM stated there is no residents in the facility.

LPA toured the facility inside and out with ADM. Living room, family room, dinning room, kitchen were observed. Two restrooms were observed. One office, 4 bedrooms, and one master bedroom with a restroom inside were observed.

No resident or staff was observed in facility.

The house was in non operational status. LPA suggested ADM to close the facility if the facility is in non operational status.

Exit interview was conducted with ADM. This report was provided to ADM for signature.