Facility Evaluation Report

Licensing Program Analyst (LPA) David Marrufo conducted an unannounced Required 1 Year visit and met with Karen Grijalva.

During visit, LPA Marrufo toured the facility inside and out. LPA toured the kitchen area and pantry building. LPA observed there to be a perishable food supply of at least two days and a non-perishable food supply of at least seven days. LPA reviewed the first aid kit and found it to be complete. The facility Emergency Disaster Drill Log indicates the last drill occurred on 07/26/2025.

LPA toured 5 out of 5 resident bedrooms. Each bedroom had working lights and available bedding and clothing storage areas. LPA toured two out of two resident bathrooms. Each bathroom had working lights and available soap and paper towels. The water temperatures in the bathrooms were 111 F and 116 F. LPA tested the carbon monoxide and smoke detectors in the hallways and resident bedrooms. Each detector functioned properly when tested.

LPA toured the outside area and observed the outdoor exit was clear of obstructions.

LPA reviewed 7 resident records, including Centrally Stored Medication and Destruction Records, and found them to be complete. LPA reviewed 8 staff records and found them to be complete.

See LIC809-C page for more information. Page 1 of 2.