Facility Evaluation Report

Licensing Program Analyst (LPA), Alviso is conducting a continued annual inspection, on 5/6/25 at approximately 9:45am, and met with Administrator Leonardo Dela Cruz. LPA observed two caregivers, Rolando Correa (Cloe), and Francisca Zamora. Annual inspection began on 4/15/2024.

Currently there are four (4) clients in care. All four clients are leaving to day program.

Facility has an approved fire clearance four (4) non-ambulatory clients. All client rooms are private. The facility does have a required infection control plan. The facility does have a required emergency disaster plan. Emergency drills are being conducted as required, last drill was held on 4/25/25.

LPA reviewed four (4) resident files. All resident files are complete.

LPA reviewed five (5) staff files. All staff have criminal record clearance as required. LPA reviewed staff training. All staff have first aid certification and CPR certification.

LPA is requesting the following documents be updated and submitted by 6/6/25:

LIC 308-Designation of Responsibility (if changes)

LIC 400 - Affidavit Regarding Client Cash Resources