Facility Evaluation Report

11/14/2025, Licensing Program Analyst (LPA) Loera conducted an unannounced Annual Required – 1 yr. inspection visit for this facility. There are currently three residents in care. Facility approved/cleared for 6 ambulatory, of which all may be non-ambulatory. Facility has a hospice waiver approved for two residents.

LPA and Administrator toured the building and grounds. The facility was found to be at a comfortable temperature. LPA observed a 2 day supply of perishable and 7 day supply of non-perishable food. Refrigerated food was found to be stored in a safe manner.

All rooms were furnished per regulation. All rooms were in good repair. Extra hygiene products and linens were available. Exits are equipped with auditory devices which were working properly during time of inspection. Water temperature in sinks accessible to residents in care were measured at 110.8 and 112.2 degrees F which is within the range of 105 to 120 degrees F per title 22 regulation. Fire extinguishers were last inspected January, 2025. Smoke/Carbon Monoxide detectors located throughout the facility were tested were found to be operational. Toxins and sharps were located in the garage and in the kitchen and were found to be secured. Medications were found to be centrally stored. LPA conducted spot medication count and found all prescription medication to be properly recorded on the Centrally Stored Medication Record.

Facilities conducts quarterly fire drills with the last one being conducted on 10/31/2025.