Facility Evaluation Report

Licensing Program Analyst (LPA) Alviso conducted a Required- 1 Year visit, on 7/16/26 at approximately 1:50pm, and met with Lead Caregiver Charles Lectan. LPA was greeted at the front door by caregiver Paul. Licensee/Administrator was out of town during the inspection,but the LPA did speak with Licensee by phone.

Fire clearance is approved for six (6) non-ambulatory, of which one(1) may be bedridden. Facility has six (6) residents in care; .All smoke alarms, which does check for carbon monoxide, were working properly during the inspection.

Facility has an approved hospice waiver for three (3) residents. Facility has an approved dementia plan of operation. Facility has an emergency disaster plan as required. Facility has an infection control plan as required. Per record reviews, last emergency disaster drills were conducted on 5/8/25 a water, electrical, and gas shut off/outage, and on 2/17/25 an evacuation drill.

LPA reviewed six (6) resident files, including medication records, and observed storage of medications.

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

Hot water was measured at 112.4 degrees Fahrenheit. All exit doors had auditory alarms. All exits were free and clear of obstructions.