Facility Evaluation Report

On July 08, 2025, 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 caregiver, Elsa Lopez, and disclosed the purpose of the inspection. The caregiver informed the LPA that the facility had five (5) residents in care and three (3) staff members present at the time.

At 8:45 AM, the LPA initiated a walk-through of the facility, accompanied by the caregiver.

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. LPA inspected a locked cabinet containing knives and sharp objects, and a locked cabinet under the sink that stored detergents and cleaning supplies. The refrigerator and pantry cabinets were inspected, and sufficient supplies of fresh perishable food for two (2) days and nonperishable staples for seven (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 (2) residents eating breakfast at the dining table.

LPA inspected the living room and observed it to be clean, with all furniture in good repair. There were sofas, a recliner chair, and a television in the living room. LPA observed one (1) resident watching TV in the living room. LPA inspected the fire extinguisher mounted on the wall in the living room and found it fully charged, with the last service tag dated 08/05/2024. The caregiver tested the smoke and carbon monoxide detector located in the hallway in LPA’s presence, and it was found to be functional.