Facility Evaluation Report

Licensing Program Analyst (LPA) Alviso conducted a Required- 1 Year visit, on 8/13/25 at approximately 10:25am, and met with Licensee Rose Aquino, and Administrator Rafael Aquino. There currently are five (5) residents in care. LPA observed two caregivers on duty upon admission into the facility.

Fire clearance approval is for six (6) non-ambulatory residents, there is no bedridden approval. Facility has an approved hospice waiver for one (1). Facility has an approved dementia plan of operation. Facility has a required infection control plan. Facility has an emergency disaster plan as required.

LPA reviewed five (5) resident files. Files were complete.

LPA reviewed four (4) staff files. All staff had required criminal record clearance. Staff had required first aid certification and CPR certification, per file reviews.

LPA toured the facility with Administrator Rafael. Facility was observed to clean and orderly. All postings were visible to all entering facility. Hot water was measured at 113. degrees Fahrenheit. All bathrooms had grab bars, and shower mats/non-slip flooring for resident use. Fire extinguisher was serviced and tagged as required. All exits were clear and free from obstruction. The bathrooms, resident rooms, hallways, and all common areas had sufficient lighting for residents' in care, and for use by residents. Facility had sufficient furnishings for resident use.Backyard was free and clear of any hazards, and backyard fire exit path was clear and free of obstruction. The backyard had patio furniture for residents' use. Exit doors had auditory alarms. Food supply was sufficient. Facility had sufficient supply of cleaners, paper products, linens. and personal protective equipment (PPE).