Facility Evaluation Report

Licensing Program Analyst (LPA) Kelly Dulek arrived at the facility unannounced to conduct a required annual visit at 11:12AM. LPA was greeted by facility staff Erlinda (Linda) Balaque. Licensee Roberto Ramirez was contacted via telephone and arrived at the facility at 11:32AM. Entrance interview conducted.

At 12:03PM, the LPA, along with the Licensee toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that facility is in compliance with Title 22 Regulations. The following was observed:

BEDROOMS: The LPA observed resident bedrooms, which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. The facility consists of 3 (three) total bedrooms, all of which are licensed for shared resident use.

RESTROOMS : The facility has 2 (two) restrooms, 1 (one) is a common restroom and the other is a private resident restroom. Restrooms are relatively clean and sanitary and in operating condition with grab bars and non-skid surfaces. Hot water was measured in both resident restrooms and measured within the required range.

COMMON AREAS : The LPA observed common area to be relatively clean and properly furnished at the time of the visit. The LPA observed the fire extinguishers to be fully charged and Licensee indicated both were purchased at the time of licensure in August 2022. Licensee is aware of the upcoming need to have the fire extinguishers serviced. Smoke detectors and carbon monoxide detector were tested at 12:24PM and were functional at the time of the visit.

KITCHEN: The LPA observed the kitchen/dining area. Kitchen appliances are in operable condition