Facility Evaluation Report

On 10/25/25, Licensing Program Analyst (LPA) L. Salazar arrived to the facility unannounced to conduct the required annual inspection. LPA was greeted by Administrator, stated the purpose of the visit and was allowed entry into the facility. Administrator on record is Leticia Villela, Certificate #7003015740, expires 10/26/25, renewal application was submitted.

LPA toured the facility inside and out. 4 out of 4 residents in care receive Regional Center services. Facility is a three bedroom two bathroom home. Resident bedrooms were observed to have the required lighting and furnishings and were free from odor and free from any passageway obstruction / fire hazards. Facility temperature was 74 degrees F.

Bathrooms were toured and observed to have operational lights, grab bars, running water, and non- slip floors. Hot water temperature tested at 110 degrees F. Trash can with lid and hand washing postings were observed. Medications were observed to be locked in cabinet(medication station) located in the hallway. Cleaning supplies were observed to be locked in a cabinet in the hallway. LPA toured the kitchen observed the required 7-day supply of non-perishable food and 2- day supply of fresh perishables to be properly stored. Outside of facility toured. All exits open and free of obstruction. No hazards observed. Facility observed to have several shaded areas with seating available outdoors.

Carbon monoxide and smoke detectors were tested and observed to be operational. Night lights were observed in the hallways. Fire Extinguisher was observed with a service date of 04/08/25. First aid kit was observed and contained all required items. Required postings were observed. Quarterly Emergency Disaster Drill logs were observed for staff. No residents are receiving Hospice services residents or receiving Home Health care service. A sample of resident and staff files were reviewed and observed to have the required forms and training records.