Facility Evaluation Report

LIcensing Program Analyst (LPA) Jill Nakagawa arrived unannounced to conduct an Inspection. LPA was met at the front door by care staff and was granted access into the facility. House Manager Ron-Mark Adriano arrived shortly. Fire Clearance approved for 8 nonambulatory, 2 of which may be bedridden.

LPA and care staff toured the one story facility, which has 6 bedrooms, 3.5 bathrooms, and large family room and kitchen. LPA observed the facility to be clean and at a comfortable temperature of 74 degrees F with all exits free from obstruction. The facility has a built in Fire Sprinkler System. LPA found the carbon monoxide detector to be operational during the inspection. The fire extinguisher was last charged on April 17, 2025 and was fully charged and operational. Last fire drill was July 5, 2025. Water temperature was 107-109 degrees and is within acceptable range of 105 to 120 degrees F. There was sufficient perishable and non-perishable foods located in the kitchen. Knives and other hazardous items were locked and inaccessible to residents in care. Medications are locked in kitchen cabinet where it is inaccessible to residents in care. Cleaning products and other toxins are located in the locked laundry room and inaccessible to residents in care. There was a supply of linens, cleaners, hygiene products and paper products available for residents. All bathrooms designated for residents were supplied with paper towels and hand soap, and outfitted with grab bars and non-slip floors/mats. A tour of the four current residents' bedrooms was conducted, and bedrooms inspected have lighting and appropriate furnishings.

LPA requested proof of LIability Insurance and an updated LIC500.

LPA found no deficiencies at the facility at the time of inspection.

Exit interview was conducted, and a copy of this report was given to House Manager.