Facility Evaluation Report

On 3/24/2022, LPA’s (Licensing Program Analysts) L. Ibo and K. Nguyen arrived unannounced to conduct continuation pre-licensing inspection due to a change of ownership. LPAs met with applicant Elena Mihale. NO resident observed during the visit.

Facility has an approved fire clearance for 6 non ambulatory residents. Last fire inspection was conducted on 1/22/2022. LPAs inspected the facility including but not limited to 6 resident rooms, 1 staff room, 1 staff bathroom and 3 residents’ bathrooms, common areas, kitchen, dining, family room, living room, courtyard area and outside areas.

LPAs toured the facility to check all the deficiencies cited on March 1, 2022.

The following deficiencies was cleared during the visit:

Bedroom #1; the only set up room for licensing inspection, with one bed, lamp shade, drawer, closet has multiple curtain rods and detached bedrail, lamps, unplugged TV, multiple comforter sets. CLEARED

Bedroom #2; LPAs observed 1 hospital bed with open empty boxes all over the floor, pillows on top of open boxes, lamp shade on the floor, garbage bags under the hospital bed, mattress leaning on the side of the wall . CLEARED