Facility Evaluation Report

Licensing Program Analyst (LPA) David Marrufo conducted an unannounced Required 1 Year Visit and met with Hector Marquez.

During visit, LPA Marrufo toured the facility inside and out.

LPA reviewed 6 resident records and 6 staff records. Resident R1's record was missing the Physician's Report. R2's record was missing the Admission Agreement. The 6 staff records were complete.

The emergency disaster drill log indicates the last drill occurred on 11/17/2025.

LPA Marrufo toured the resident restroom. The water temperature measured at 112 F. There was available soap and paper towels and working lights.

LPA toured the outside of the facility and saw the outdoor exits were clear of obstructions.

A deficiency was cited as per California Code of Regulations Title 22. See LIC809-D page for more information.

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