Facility Evaluation Report

Licensing Program Analyst (LPA) David Marrufo conducted an unannounced Required 1 Year Visit and met with Stephanie Silva, Administrator (ADM).

During visit, LPA toured the inside and outside of the facility. LPA toured two out of two bathrooms. Each bathroom had working lights and available soap and paper towels. The water temperatures in the bathroom sinks were 106 F and 113 F. LPA reviewed the first aid kit and found it to be complete.

LPA toured three out of three resident bedrooms. Each bedroom had working lights and available bedding and clothing storage areas. During visit, staff tested the smoke and carbon monoxide detection system and it functioned properly when tested.

LPA toured the outside area of the facility and observed the outdoor exits to be clear of obstructions.

LPA reviewed three out of three Centrally Stored Medication and Destruction Records and found them to be complete. LPA reviewed three out of three Personal and Incidental Money Logs and found them to be complete. LPA reviewed three out of three resident records and seven staff records and found them to be complete.

The emergency disaster drill log indicates the last drill was conducted on 10/14/2025.

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