Facility Evaluation Report

On 06/12/2025, Licensing Program Analyst (LPA) Arielle Pascua arrived unannounced to conduct an annual visit. LPA met with Facility Designated Administrator (FDA), Rommel Molina and explained the purpose of the visit. There was one other staff member present, Sheila Coronado.

This facility is licensed to serve residents 60 and older, of which all 5 may be non-ambulatory and 1 may be bedridden in bedroom 4. This facility also holds a hospice waiver for 6 and has a dementia plan on file.

Current census was 6. A brief interview with FDA Molina was conducted.

LPA reviewed 6 resident files. 6 resident files were complete and up to date.

The Facility Designated Administrator, Rommel Molina, hold a current and administrator certificate #67025966740 and expires on 09/28/2025.

Tour of the facility was conducted. Carbon monoxide and smoke alarms were present and were in working condition.

Common areas for resident use were toured. Furniture and furnishings were observed to be present and in compliance.

A tour of the bathrooms was conducted. Hot water temperatures were taken to ensure that the hot water being dispensed was within the allowed range of 105-120 degrees at this time. Grab bars were present and functional.

Resident bedrooms were toured. Furniture and furnishing were observed to be present and in good condition.

A linen closet was located in the hallway. LPA observed a sufficient amount of linens at this time.