Facility Evaluation Report

On 08/07/25, Licensing Program Analyst (LPA) L. Salazar arrived to the facility unannounced to conduct the required Annual Inspection Visit. LPA was greeted by Administrator, stated the purpose of the visit and was allowed entry into the facility. Administrator on record as of 07/18/25 is Daniel Flores #7028247735 Expiration 12/27/26. Administrator certificate is observed posted on the wall. LPA is currently processing Administrator change.

LPA conducted a tour of the facility, inside and out. Facility is a 4 bedroom 2 bathroom home. Private resident bedrooms were observed to have the required lighting and furnishings and were free from odor and free from any passageway obstruction or fire hazards. LPA observed the required 7-day supply of non-perishable food and 2- day supply of fresh perishables to be properly stored. An emergency disaster supply was observed.

Bathrooms were toured and observed to have operational lights, running water, and non- slip floors. Hot water temperature tested at 110 degrees F. Trash can with lid and hand washing postings were observed. Internet device and a working phone line were observed to be available for residents in care. A supply of extra linen's and towels were observed in the hallway.

Carbon monoxide and smoke detectors were observed to be operational. Carbon Monoxide detectors are located in Living Room, kitchen and both hallways leading to the bedrooms. A State Fire Marshall approved automatic fire sprinkler system was observed to be operational. Night lights were observed in the hallways. Fire Extinguisher was observed with a service date of 06/30/25. First aid kit was observed and contained all required items. Resident file was reviewed and observed to have update emergency contact information, Admission agreement, and current medical assessment, Individual Performance Plans, Individual Behavioral Support Plans, and an Individual Emergency Intervention Plan and Needs and Service plans.