Facility Evaluation Report

On 07/23/2026 at 12:44 PM, Licensing Program Analyst (LPA) Ardalan Gharachorloo arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with care staff Rose Marie Simpson and explained the purpose of the visit. LPA called the administrator, Samuel Tet at 12:53 PM to explain the reason for the visit and left a voicemail. Administrator Samuel Tet was not present during the inspection.

LPA toured facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 71 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 107.5 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of non-perishable and 2 day of perishable foods. Centrally stored medication and sharps were locked and inaccessible to residents.

Smoke detectors and carbon monoxide detectors were in operating condition during visit. Fire extinguisher was last serviced on 03/16/2026. Emergency Disaster Plan was last reviewed on 04/20/2026. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 04/30/2026.

LPA reviewed 5 residents records and 5 staff records; all were complete. LPA also reviewed a sample of resident’s medications. The updated copies of the following documents were requested to be submitted to LPA by 07/30/2026:

Administrator's Certificate # 7001579740 expires on 11/29/2027.

No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.