Routine inspection·September 3, 2025

Licensing Program Analyst (LPA) Mariana Agban conducted an Annual Required visit and inspection of the facility. Upon arrival, LPA was greeted by staff and explained the reason for the visit. Shortly after, LPA met with Licensee Martin Manzano and explained the reason for the visit. Administrator, Aida Amante was also present during the annual inspection. At approximately 2:15 PM, with the assistance of the Licensee, LPA took a tour of the physical plant, and the following were observed: Required postings were observed in the entry area. The smoke alarms are interconnected and battery-operated. The smoke alarms and the carbon monoxide were tested and they were properly function. Kitchen : The kitchen appliances and fixtures were functional. LPA found a sufficient amount of perishable and non-perishable food at the facility; properly stored. Knives were stored in a locked drawer in the kitchen. Properly labeled medications were locked in one of the kitchen cabinets. The fire extinguisher is located in the kitchen with the purchase date 08/28/25. Bedrooms : There were five (5) bedrooms in the facility. Four (4) are designated for residents' use and one (1) for staff use. Two (2) bedrooms are shared and two are private. All bedrooms were clean, properly furnished, and had sufficient lighting. Bathrooms : There are two (2) bathrooms designated for residents' use. One (1) bathroom in the hallway which is the main, and one (1) in room #3. Both bathrooms were properly supplied and had functional fixtures. Hot water temperature was measured from the bathroom sink at 107.5 and 106.5 degrees Fahrenheit. No cleaning supplies or hazardous items were present in each bathroom during the inspection. (Continue on 809C) Common Areas : These included the living room and dining area. The common areas were properly furnished. The dining room table is large enough to sit the capacity of the facility. Seating such as couches were in good repair and sit the capacity of the facility. The auditory alarms on all exit doors were on and functional at the time of the visit. Surrounding Grounds : Entry/exits were free of obstruction. There was furniture appropriate for outdoor use. The outdoor area was free of hazards. Laundry Area : located through the kitchen. Appliances observed to be in good repair. Laundry detergents were locked inaccessible to residents. Garage : was observed to be only used for storage. Resident Files : LPA conducted a file review for 1 out of 6 residents to ensure compliance with licensing forms. LPA interviewed 6 out of 6 residents. Temperature : Facility maintains a comfortable temperature of 79 degrees Fahrenheit. Due to time constraints, LPA was unable to complete the annual inspection during today's visit. Administrator was informed that a follow up visit will be conducted. During today's the facility was in compliance with Title 22 regulations. No immediate health and safety risks were observed. Exit interview conducted. Copy of report provided