Facility Evaluation Report

Licensing Program Analyst (LPA) Alviso, conduct a Required- 1 Year inspection, on 9/17/25 at about 1:50pm, and met with Administrator Ryanne Tapnio. LPA observed a caregiver,Mielo, on shift upon LPA's arrival. Five residents are in care, and one resident is currently hospitalized.

Facility has a required infection control plan. Facility has a required emergency disaster plan. Facility has an approved hospice waiver for two (2) residents. There is an approved plan of dementia care. Fire clearance is approved for six (6) non-ambulatory, of which one may be bedridden.

LPA is requesting the following documents be updated and submitted by 10/17/25

LIC308 - Designation of Administrator Responsibility

LIC610E 9-pages-Emergency Disaster Plan (review and update as needed/required) Submit if any changes.

Infection Control Plan- (review and update as needed/required) Submit if any changes.

Copy of LIC400 Handling of Client Cash Resources -complete & submit (required form)

LPA and Administrator toured the facility. The LPA observed the following: All exits were free and clear of obstruction. Hot water was measured at 109.4 degrees Fahrenheit, which is within regulation.