Facility Evaluation Report

On 10/07/2025, Licensing Program Analyst (LPA) Arielle Pascua arrived unannounced to this facility to conduct an annual visit. LPA was greeted by Facility Designated Administrator (FDA), Kalven Goreal and explained the purpose of the visit.

Current census was 4. A brief interview with FDA Goreal was conducted.

This facility is licensed to serve and retain 6 non-ambulatory residents to resident in bedrooms 1 through 3. This facility also holds a dementia plan on file and a hospice waiver for 2.

LPA Pascua reviewed 4 resident files and 3 staff files. The Facility Administrator has a current administrator certificate #7009180740 and expires on 12/23/2025.

The fire extinguisher, located throughout the facility was serviced on 08/22/2025.Carbon Monoxide and fire alarms were present and in good repair.

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.

The kitchen area was toured. Facility freezer and refrigerator showed to be functional and in compliance at this time. A tour of the pantry was conducted. LPA observed that there was a 7-day nonperishable food supply at this time.