Facility Evaluation Report

Licensing Program Analyst (LPA) Valeria Conway arrived unannounced to conduct a one year required annual at 9:15 A.M. Upon arrival, the LPA was greeted at the door by caregiver, Marietta Acosta and contacted the administration via telephone. At 9:39 AM the Administrator, Sara Jackson arrived at the facility and the reason for the visit was explained. Entrance interview conducted.

At 9:35 A.M., the LPA along with the administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. The following observed:

KITCHEN : Kitchen appliances appeared to be in operable condition. The facility has a sufficient supply of perishable and non-perishable food at the time of the visit. All knives were observed to be locked in a kitchen drawer. At 9:40 A.M. hot water measured 116.8 degrees Fahrenheit. LPA observed a fire extinguisher fully charged and recently purchased on 07/07/2025.

BEDROOMS: The LPA observed the resident bedrooms, which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. There are 6 (six) bedrooms in total. Room between kitchen and garage is designated as a staff room.

RESTROOMS: The LPA observed three (3) restrooms in the facility. Resident restrooms were observed to be clean and sanitary and in operating condition with grab bars and slip-resistant surfaces. During the physical plant tour, LPA observed that the sink located in the hallway bathroom, situated between bedroom #2 and bedroom #3, was not draining properly (TA issued). Hot water temperature was measured in all three (3) restrooms and was within the required range of 105 - 120 degrees Fahrenheit.