Facility Evaluation Report

On 04/26/2024, Licensing Program Analyst (LPA) Arielle Pascua arrived unannounced to this facility to conduct an annual visit. LPA met with Facility Designated Administrator (FDA), Maricel Casillas.

This facility is licensed seeking to accept and retain up to 4 residents, of which 3 may be ambulatory with 1 resident who can be non-ambulatory at any given time. This facility is awaiting vendorization to accept and retain Level 4I residents at this time.

The facility designated Administrator, Maricel Casillas, did have her Administrator certificate posted with an expiration date of #7018782735 and expires at 07/16/2025 and in compliance at this time.

A review of the facility personnel file for the facility designated Administrator was conducted.

Common areas were toured. Dining area, living area, and all other areas intended for resident use were observed to be furnished and maintained in compliance at this time.

Kitchen area was toured. Cabinets and drawers were reviewed.

Fire extinguisher, hanging on kitchen wall, was observed to have been annually purchased from the local home improvement store with receipt attached at this time.

Cabinet below the sink was reviewed. It was observed to contain cleaning agents and supplies which were locked and made inaccessible at this time.

A tour of the facility resident bedrooms was conducted. Furnishings and furniture were observed to be sufficient and able to meet the needs of the residents at this time.

A tour of the facility resident restrooms was conducted. Grab bars and nonskid mats were observed to be present and in good repair at this time.

Hot water temperatures were taken to make sure that they were within the allowed range of 105-120 degrees at this time.

Food storage supply was reviewed. This LPA observed 2-day perishable food supplies and 7-day nonperishable food supplies at this time.