Facility Evaluation Report

On January 21, 2025, at 09:00 AM, the Licensing Program Analyst (LPA) Kiran Jain arrived unannounced at the facility to conduct a Required 1-Year Annual inspection. The LPA met with the DSP, Jocelyn Ternida, and disclosed the purpose of the inspection. The Licensee, Corina Ancheta, joined shortly thereafter. The LPA reminded the licensee that their Annual licensing fees were not current and were due. The DSP informed the LPA that the facility had (6) residents in care and (2) staff members present at the time.

At 9:20 AM, the LPA initiated a walk-through of the facility, accompanied by the DSP.

LPA inspected the kitchen and found it clean, with breakfast preparation and cooking in progress at the time. The appliances were checked and observed to be in working order. The LPA inspected a locked cabinet containing knives and sharp objects, and a locked cabinet under the sink with detergents and cleaning supplies. The refrigerator and pantry cabinets were inspected, and sufficient supplies of fresh perishable food for (2) days and nonperishable staples for (7) days were observed. No expired food or stored medications were noted.

LPA inspected the dining area adjacent to the kitchen and found it clean. The dining table and chairs were observed to accommodate the residents, and all the furniture was in good repair. The LPA observed two residents eating breakfast with assistance from a caregiver at the dining table. The LPA inspected the living room and observed it clean, with all furniture in good repair. There was a set of couches and a television in the living room.

The LPA inspected the fire extinguisher mounted on the wall in the dining area and found it fully charged, with the last service tag dated 01/10/2025. The DSP tested the smoke and carbon monoxide detector located in the hallway in the LPA's presence, and it was found to be functional.