Facility Evaluation Report

Licensing Program Analysts (LPA) B. Miranda conducted an unannounced visit today for the facility’s annual inspection. LPA introduced themselves and was allowed entrance into the facility. LPA met with Administrator Kristyn Leyva.

Facility is licensed for 6 residents and has a current census of 5. Water temperature was checked in the kitchen which read at 107.9 degrees Fahrenheit. Fire Extinguisher was serviced January 12, 2026, and is within the safety regulation period. Smoke and carbon monoxide detectors were tested and in working order.

Kristyn Leyva Administrator's Certification expires January 8, 2028. Staff files were reviewed, are completed, and current. Resident files were reviewed, completed, and current. Facility provided a log for disaster drills that are conducted quarterly. First aid kit on site and complete. Toxins and cleaning supplies are locked and inaccessible. There is a locked storage for medications.

LPA reviewed R1’s medication. Centrally stored medication log is not completed and the MARS do not have the necessary information. R1’s physician report indicated R1 is not able to communicate their needs. Medications are not being completed logged with start dates and expiration dates. Docusate 100MG CAP & Hydroxyzine HCL 10mg TAB were not logged on the PRN log.

LPA observed stains in R2’s carpet, windowsills have insect and debris, R3 bed is worn, common bathroom shower curtain needs to be cleaned (inside), and kitchen cabinet with lids needs to be wiped down from debris.