Facility Evaluation Report

On 10/9/2025 Licensing Program Analyst (LPA) B. Miranda arrived to the facility unannounced to conduct an annual inspection. LPA was greeted by staff Teresa Molina and allowed entrance into the facility. Administrator Davilyn Mancilla was contacted and arrived shortly after.

Upon entering the facility LPA observed the facility to be clean,clutter & odor free. Facility is currently licensed for 6 residents and has a current census of 5. LPA observed all exits to be free from obstruction. Fire extinguisher was last serviced on 7/15/2025. Back yard is properly secured. LPA observed smoke alarm and carbon monoxide reader to be in working order. Facility does not have any bodies of water such as pool, spa, fountains, etc. Facility has a wood buring fireplace that is not in use & is blocked from view with large wallhanging.

LPA observed kitchen to be clean and free from any pests. Facility has adequate amount of food with 7 days supply of non-perishable food items and 2 day supply of perishable food items. LPA observed sharps to be inaccessible in a locked cabinet. Medication is locked in cabinet and inaccessible to residents.

LPA observed resident rooms to be clean and odor free. Rooms were properly furnished with sufficient lighting. LPA observed bathroom to be clean with pull bars and non-slip matts. Water temperature read at 106.9 degrees Fahrenheit in the bathroom.

LPA reviewed resident files to be complete and current. LPA reviewed administrator and staff on duties files. Exit interview was conducted and a copy of this report LIC809 was provided to Administrator Davilyn Mancilla.