Facility Evaluation Report

Licensing Program Analyst (LPA) Alviso conducted a continued annual inspection, on 1/20/26 at approximately 1:55pm, and met with Administrator Monicah Gacegu.

Fire clearance is approved for eight (8) non-ambulatory only. Currently there are five (5) residents' in care.

Facility has an approved dementia plan of operation. There is an approved hospice waiver for three (3) residents. The facility has a required infection control plan. The facility has a required emergency and disaster plan.

LPA reviewed five (5) resident files, including storage of medications and medication records. All files were complete. LPA reviewed resident's hospice file, including medication orders.

LPA reviewed three (3) staff files, including training. All staff have required criminal record clearance. All staff have first aid and CPR certification.

LPA toured the facility with Licensee Monicah Gacegu. The LPA observed that the facility was at a comfortable temperature during the inspection. The facility had a sufficient supply of food. There is a cabinet in the kitchen to lock all medications and make them inaccessible to residents in care. Disinfectants/cleaners were locked up and inaccessible to residents in care. Facility had a sufficient supply of paper products, linens, soap, sanitizer, hygiene products, and personal protective equipment (PPE). There was sufficient lighting in hallways, resident rooms, bathrooms, and common areas. Bathrooms had grab bars, and non-skid mats for the shower for residents' use. Facility had sufficient furnishings for resident use. All facility utilities were on, and working as required. Continued on LIC809C..