Facility Evaluation Report

Licensing Program Analyst (LPA) Valeria Conway arrived at the facility to confirm the census of the facility and conduct a physical plant tour to verify if the sketch recently received matches with the layout of the property. The LPA was greeted by an individual named "Jess". Caregiver, Arlina Caranay, contacted the Administrator by phone, Onyx Pacheco. The administrator informed that they would arrive at the facility in a few hours and stated they would contact back up administrator, MayAnn Reyes to assist until their arrival. The back up administrator arrived at the facility at 9:25 A.M. and the Administrator arrived at 2:00 P.M. Reason for the visit was explained Entrance interview conducted.

On 11/10/2025 Community Care Licensing received a capacity change request submitted by administrator Onyx Pacheco, proposing to decrease the facility's capacity from six (6) residents to four (4) residents in order to become vendorized by Tri-Counties Regional Center.

During today's visit, at 9:38 A.M., the back up administrator contacted the administrator by phone to discuss the sketch submitted with the capacity change documents. The LPA clarified that the sketch requires revision before any changes can be approved. The administrator agreed to submit a revised sketch to LPA in the coming days.

Exit interview conducted. A copy of this report was provided.