Facility Evaluation Report

At approximately 9:45 AM Licensing Program Analyst (LPA) Star Stevenson arrived unannounced to CONTINUE a required 1-year annual inspection and was greeted by caregiver Irene Llantero who has Designation of Facility Responsibly (RP) Licensee Omar Chiong was called and arrived at approximately 10:15 AM to further assisted with today's continued inspection.

At approximately 9:55 AM LPA reviewed three (3) of 3 staff files and found that all 3 had required employment documentation as required by title 22.

At approximately 10:40 AM LPA reviewed six (6) resident files and observed all 6 to have required documentation. Facility has a hospice waiver for three (3) residents and currently two (2) of six (6) residents are receiving hospice care with hospice care plans on file.

At approximately 11:15 AM medicines were found to be centrally stored and secure and a record of their administration accurate.

Facility does not handle resident cash resources.

Facility is aware that an Emergency/Disaster Drill is to be performed every 3 months and last conducted a drill on 12/12/2025

Facility participated in Technical Support Services (TSP) as a newly licensed facility