Facility Evaluation Report

At 8:40am on 06/29/2026, Licensing Program Analyst (LPA) Jeffries arrived to the facility unannounced to conduct the facility annual inspection. LPA met with facility Administrator, Hermi Gonzales, announced who he is and the reason for the visit.

Administrator and LPA conducted a physical tour of facility, LPA noted that this is a seven bedroom, one full bath, three on-sute baths rooms (Rooms 2, 3, 4), kitchen, dining room, living room and activity room, and the laundry is located in the garage. There is a staff bedroom located near the front entrance. There is a large L-shaped back yard with seating and umbrellas for client activities and visitation. LPA noted that all residents rooms meet regulation standards in bedding, furniture, lighting and facility temperature. LPA noted that all rooms have exits to the backyard and have auditory devices on the doors which were tested and functioning. LPA noted that there is at least 2 days of perishable food and at least 7 days on non-perishable foods on hand for six residents and staff. LPA noted that the facility has emergency water stored in the garage area. LPA noted that the facility water temperature was tested throughout the facility to be in regulation standards of 105*(f)-120*(f). LPA noted that the facility was a comfortable temperature of 70*(f). LPA noted that all door ways, passage ways and exits were free and clear of debit. LPA noted that the fire extinguisher located near the front entrance was primed and in the green, indicating working. LPA noted that the carbon monoxide detector was tested and working, as well as hardwired and battery smoke detectors in each resident room. LPA noted that there is a full first aide kit located in a locked cabinet where the medications are locked and stored. LPA reviewed facility emergency disaster plan, infection control plan, liability insurance, plan of operations, resident and staff files including annual staff training. LPA also reviewed resident Centrally Stored Medication Records (CSMR) LPA noted no citations during the physical tour of the facility.

Administrator and LPA conducted a full review of the annual care tools. LPA noted no citations during this annual inspection. Exit interview, report read, and report provided.