Facility Evaluation Report

Unannounced Annual visit made out to this facility on 04/21/2026 by Licensing Program Analyst (LPA) Charlie Yang. This LPA was met by the facility caregivers, Remedios VeBelen and Linda Aguilar, who were briefly interviewed at this time. This LPA requested that they go ahead and contact the facility designated Administrator to inform them that CCL was present at this time. The facility designated representative, Voica Matis, was present at this time and was briefly interviewed at this time.

Current census was 5 residents. It was learned that there were (3) residents under the care of hospice at this time. This facility does have an approved waiver to be able to accept and retain up to (3) residents under the care of hospice at any given time.

It was learned that this facility has a program to be able to accept and retain dementia residents at any given time. It was learned that there were (3) residents diagnosed with dementia at this time. It was learned that there weren't any residents receiving services through home health at this time. It was learned that this facility does not have an approved bedridden fire clearance to be able to accept or retain any residents deemed to be bedridden at any given time.

Dining area, living area, and all other areas intended for resident use were toured. Furniture and furnishings were observed to be sufficient and able to meet the needs of the residents at this time.

Linen closet, located in facility hallway closet, was reviewed and observed to contain a sufficient supply of towels, sheets, and bedding able to meet the needs of the residents at this time.

Kitchen area was toured. Kitchen drawers and cabinets were opened and reviewed.

Food supply for 2-day perishable and 7-day nonperishable quantities was reviewed to make sure that they were in compliance at all times.