Facility Evaluation Report

Licensing Program Analyst (LPA) Esther Cortez arrived at the facility unannounced to conduct a required annual visit at 8:45AM. The LPA met with staff and explained the reason for the visit. Administrator Arlene Martinez arrived shortly thereafter. Entrance interview conducted.

Beginning at 8:55AM, the LPA, along with Caregiver Avelina Giron 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: Facility is a double-story residence, second floor is solely designated for staff. Fire extinguisher was fully charged with purchase date of 04/30/2025. Hardwired smoke and carbon monoxide detectors were tested at 09:17AM and all were functional at the time of the visit. LPA observed exit alarms by all doors which were functional during the visit.

KITCHEN: LPA inspected the kitchen at 9:50AM. Knives are locked in a drawer next to the sink and cleaning supplies are stored inaccessible in a locked cabinet under the sink. Kitchen appliances were in operable condition. The facility has a sufficient supply of perishable and non-perishable food.

BEDROOMS : There are 4 (four) total resident bedrooms in the facility; 2 (two) are designated as private resident rooms and 2 (two) are designated as shared rooms. Bedrooms #1 and #4 have exits to the exterior and attached bathrooms. All resident rooms are set up with beds, night stands, lamps, chests of drawers, chairs and closet space.. The bedrooms were large enough to allow for easy passage. All resident rooms were observed to be furnished appropriately with clean linens, appropriate furnishings and sufficient lighting.

COMMON AREAS : This includes the living room, dining area, and office room. LPA observed common areas to be clean and properly furnished at the time of the visit. Report Continued on LIC 809-C, 2nd page.