Facility Evaluation Report

Licensing Program Analyst (LPA) Jason Lund arrived unannounced to conduct an one year required annual visit. LPA Lund met with Licensee Edith Rodriguez and explained the reason for the visit. Census: 5

LPA Lund & Licensee Edith Rodriguez toured/inspected the interior and the exterior of the facility including the common living spaces, resident bedrooms and bathrooms, activity rooms, medication storage, kitchen, garage and outdoor areas. Bedrooms were clean and in good repair. There is a locked storage for medications. Food supply is adequate for 2-day perishable and 7-day nonperishable. Fire extinguisher were done on (10/2/2025) and is in compliance. Smoke alarms were tested and are operational. The home has a carbon monoxide detector and performs disaster drills as required. Water temperature was tested at 112 degrees.

First Aid kit is on site and complete. Toxins and cleaning supplies are locked and inaccessible. LPA Lund reviewed two staff & two residents files and were in compliance at this time.

There were no deficiencies observed or cited during today's inspection per California Code of Regulations, Title 22.

Exit interview conducted with Licensee Edith Rodriguez and copy of report left at facility