Facility Evaluation Report

At approximately 1:45 PM, Licensing Program Analyst (LPA) Star Stevenson arrived unannounced to begin a required 1-year annual inspection and was greeted by caregiver Alexander Olayvar

Facility is a Residential Care Facility for the Elderly (RCFE) licensed for 6 residents with five (5) residents in care. Facility has a Hospice waiver for two (2), with 2 hospice residents currently in care, and is approved for all non-ambulatory residents.

At approximately 02:00 PM Administrator/Licensee -Claribelle Bailon arrived.

At approximately 02:05 PM, LPA initiated a tour of the facility with licensee and observed the following: Facility is a one story home, was a comfortable temperature, and passageways were free from obstructions. Fire extinguishers were last inspected 02/2025 and were observed to be fully charged . Water temperatures measured 114.2F and 115.8F. LPA observed a supply of clean linens, hygiene, incontinent care, and paper products available for residents. Residents' bedrooms were inspected and observed to have all the appropriate furnishings as outlined in Title 22 regulations. Cabinets containing cleaning supplies and other items that could pose a risk were locked. Two (2) staff areas noted on the facility sketch with one (1) staff member noted to have personal meds in a locked box in a staff room. No firearms are in the home.

LPA observed at least a 2-day supply of a variety of healthy and perishable foods, 7-day supply of non-perishable food, and emergency water supplies. In addition, a variety of snacks and fruits were observed to be set out for residents. Food was found to be stored in a safe manner with open items covered and date.